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(Chest. 1969;55:306-309.)
© 1969 American College of Chest Physicians

The Electrocardiographic Syndrome of Superior Axis and Right Bundle Branch Block

Edwin L. Rothfeld M.D., F.C.C.P.1; I. Richard Zucker M.D., F.C.C.P.1; Romeo Tiu M.D.1; and Victor Parsonnet M.D.1

1 Newark Beth Israel Hospital Institute, Newark, New Jersey

Electrocardiograms demonstrating QRS complexes of supraventricular origin were obtained on 55 of 82 consecutive patients referred for management of Stokes-Adams episodes related to intermittent or permanent complete heart block. The combination of superior axis in limb leads and right bundle branch block in chest leads occurred in 22 cases and was the most common QRS abnormality. This pattern, a manifestation of partial bilateral bundle branch block, is a frequent precursor of complete heart block. Patients whose electrocardiograms show superior axis and right bundle branch block must be observed for symptoms related to complete heart block and are potential candidates for pacemaker implantation.






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