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Related Experiment Videos

When should we diagnose incomplete right bundle branch block?

A T Mauric1, N J Samani, D P de Bono

  • 1Department of Cardiology, University of Leicester, UK.

European Heart Journal
|May 1, 1993
PubMed
Summary
This summary is machine-generated.

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Electrocardiogram (ECG) patterns with an rSr' in right precordial leads can indicate incomplete right bundle branch block or be normal. Specific ECG features, like S wave changes and QRS duration, help differentiate these conditions.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • The rSr' pattern in right precordial leads (V1, V2) with QRS duration < 0.12s presents a diagnostic challenge.
  • This pattern can represent either incomplete right bundle branch block (IRBBB) or a normal variant.

Purpose of the Study:

  • To identify specific electrocardiogram (ECG) features that differentiate IRBBB from normal variants.
  • To analyze ECGs of patients who progressed from normal to complete right bundle branch block (CRBBB) via an intermediate rSr' pattern.

Main Methods:

  • Analysis of ECGs from 15 patients who progressed from normal to CRBBB through an intermediate rSr' pattern.
  • Evaluation of ECGs from 79 subjects with an rSr' pattern and QRS duration < 0.12s, categorized by SV1/SV2 ratio.

Related Experiment Videos

Main Results:

  • Key features preceding or accompanying the rSr' pattern in progressing patients included S wave depth diminution (100%), inverted S wave depth ratio (93%), S wave slurring (27%), and QRS duration prolongation to >= 0.10s (73%).
  • Subjects with an SV1/SV2 ratio > 1.0 were significantly older (59.8 vs 32.8 years), more likely to show S wave slurring (37% vs 0%), and had a higher incidence of QRS duration >= 0.10s (74% vs 7%) compared to those with a ratio < 1.0.

Conclusions:

  • Specific ECG findings in right precordial leads, such as S wave changes and QRS duration, are valuable in distinguishing between incomplete right bundle branch block and normal variants.
  • The presence of S wave slurring and prolonged QRS duration (> or = 0.10s) in the rSr' pattern is more indicative of underlying right bundle branch block progression.