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. 1982 Sep;48(3):217–221. doi: 10.1136/hrt.48.3.217

Significance of complete right bundle-branch block when an isolated finding. An echocardiographic study.

M Dancy, G Leech, A Leatham
PMCID: PMC481232  PMID: 7104112

Abstract

Twenty-seven patients with complete right bundle-branch block as the only abnormal finding were studied using high speed M-mode echocardiography to determine the effect of the electrical delay on the mechanical events of right ventricular systole. Pulmonary valve opening (PVOm) was delayed in all cases. In some the delay was mainly between mitral valve closure (MVC) and tricuspid valve closure (TVC), and this was designated proximal block. In the others the main delay was between tricuspid valve closure and pulmonary valve opening and this was designated distal block. The patients were divided into those with proximal and those with distal block by calculating the ratio TVC-PVOm/MVC-TVC. Twelve out of 13 of those with distal delay but only one out of 14 of those with proximal delay had episodes of syncope or near syncope. These results are consistent with previous theories about the pathophysiology of right bundle-branch block. Echocardiography may offer a non-invasive method to estimate the prognosis in isolated right bundle-branch block.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BRAUNWALD E., MORROW A. G. Sequence of ventricular contraction in human bundle branch block; a study based on simultaneous catheterization of both ventricles. Am J Med. 1957 Aug;23(2):205–211. doi: 10.1016/0002-9343(57)90194-8. [DOI] [PubMed] [Google Scholar]
  2. Brooks N., Leech G., Leatham A. Complete right bundle-branch block: echophonocardiographic study of first heart sound and right ventricular contraction times. Br Heart J. 1979 Jun;41(6):637–646. doi: 10.1136/hrt.41.6.637. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Crews T. L., Pridie R. B., Benham R., Leatham A. Auscultatory and phonocardiographic findings in Ebstein's anomaly. Correlation of first heart sound with ultrasonic records of tricuspid valve movement. Br Heart J. 1972 Jul;34(7):681–687. doi: 10.1136/hrt.34.7.681. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Davies M., Harris A. Pathological basis of primary heart block. Br Heart J. 1969 Mar;31(2):219–226. doi: 10.1136/hrt.31.2.219. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Haber E., Leatham A. Splitting of heart sounds from ventricular asynchrony in bundle-branch block, ventricular ectopic beats, and artificial pacing. Br Heart J. 1965 Sep;27(5):691–696. doi: 10.1136/hrt.27.5.691. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Horowitz L. N., Alexander J. A., Edmunds L. H., Jr Postoperative right bundle branch block: identification of three levels of block. Circulation. 1980 Aug;62(2):319–328. doi: 10.1161/01.cir.62.2.319. [DOI] [PubMed] [Google Scholar]
  7. LENEGRE J., MOREAU P. LE BLOC AURICULO-VENTRICULAIRE CHRONIQUE. ETUDE ANATOMIQUE, CLINIQUE ET HISTOLOGIQUE. Arch Mal Coeur Vaiss. 1963 Aug;56:867–888. [PubMed] [Google Scholar]
  8. Millar K., Burgess M. J., Abildskov J. A., Eich R. H. Dependence of intraventricular pressures on activation order before and after experimental Purkinje net block. J Electrocardiol. 1970;3(1):51–56. doi: 10.1016/s0022-0736(70)80071-1. [DOI] [PubMed] [Google Scholar]
  9. ROSENMAN R. H., PICK A., KATZ L. N. The electrocardiographic patterns and the localization of intraventricular conduction defects; a survey of the method of approach and tentative conclusions. Am Heart J. 1950 Dec;40(6):845–866. doi: 10.1016/0002-8703(50)90182-7. [DOI] [PubMed] [Google Scholar]
  10. Rotman M., Triebwasser J. H. A clinical and follow-up study of right and left bundle branch block. Circulation. 1975 Mar;51(3):477–484. doi: 10.1161/01.cir.51.3.477. [DOI] [PubMed] [Google Scholar]
  11. SMITH L. A., FIELDS J., KENNAMER R., PRINZMETAL M. Studies on the mechanism of ventricular activity. III. Contraction of the ventricles in experimental bundle branch block. Am Heart J. 1952 Aug;44(2):231–237. doi: 10.1016/0002-8703(52)90147-6. [DOI] [PubMed] [Google Scholar]
  12. ZOOB M., SMITH K. S. THE AETIOLOGY OF COMPLETE HEART-BLOCK. Br Med J. 1963 Nov 9;2(5366):1149–1153. doi: 10.1136/bmj.2.5366.1149. [DOI] [PMC free article] [PubMed] [Google Scholar]

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