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Related Experiment Videos

Effect of bundle branch block on local electrogram morphologic features: implications for arrhythmia diagnosis by

B H Sarter1, B G Hook, D J Callans

  • 1Clinical Electrophysiology Laboratory, Philadelphia Heart Institute, PA 19104, USA.

American Heart Journal
|May 1, 1996
PubMed
Summary
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Bundle branch block (BBB) during supraventricular tachycardia alters ventricular electrogram morphology. Changes are most prominent at recording sites ipsilateral to the BBB, impacting implantable cardioverter defibrillator diagnoses.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Diagnostics

Background:

  • Local ventricular electrograms aid in evaluating patients with implantable cardioverter defibrillators.
  • Distinguishing ventricular tachycardia from supraventricular rhythm relies on electrogram morphology.
  • The impact of bundle branch block (BBB) on electrogram morphology during supraventricular tachycardia is not fully understood.

Purpose of the Study:

  • To investigate if bundle branch block (BBB) changes local ventricular electrogram morphology.
  • To determine if these changes are site-dependent.
  • To assess implications for interpreting stored electrograms in implantable cardioverter defibrillator therapy.

Main Methods:

  • Retrospective review of local electrogram recordings from 23 patients with intermittent BBB during supraventricular tachycardia.

Related Experiment Videos

  • Comparison of recordings during BBB-induced supraventricular tachycardia with narrow complex supraventricular tachycardia or normal sinus rhythm.
  • Analysis of recordings from right ventricular apex and coronary sinus using bipolar leads (5 mm interelectrode distance, 40-400 Hz filter).

    • Main Results:

    • Right BBB caused morphologic changes in 85% of right ventricular apex recordings vs. 8% of coronary sinus recordings.
    • Left BBB caused morphologic changes in 100% of coronary sinus recordings vs. 8% of right ventricular apex recordings.
    • Morphologic changes were predominantly observed at recording sites ipsilateral to the BBB.

    Conclusions:

    • Bundle branch block significantly alters local ventricular electrogram morphology.
    • These alterations are site-specific, affecting ipsilateral more than contralateral recording sites.
    • Understanding these BBB-induced changes is crucial for accurate interpretation of stored electrograms and implantable cardioverter defibrillator therapy.