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(Chest. 1972;61:388-392.)
© 1972 American College of Chest Physicians

Cycle Length-Dependent Left and Right Bundle Branch Block and Left Anterior Hemiblock

Dan Feigl M.D.1 and Abraham Marmor M.D.1

1 Internal Department, Shmuel-Harofe Government Hospital, Beer Jaakov, Israel

A patient in whom rate dependent trifascicular block was recorded is described. The first manifestation was right bundle branch block (RBBB) with extreme left axis deviation, eg, left anterior hemiblock (LAH) accompanied by a 2:1 atrioventricular block. In later recordings it proved to be transient, appearing without manifest changes in heart rate. On following recordings complete left bundle branch block developed, its presence being dependent upon a short ventricular diastole preceding it. A third distinctly different pattern was that of rate-dependent RBBB combined with a progressive block in the anterior division of the left bundle branch. This resulted in a peculiar cyclic change of the RBBB pattern.






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Copyright © 1972 by the American College of Chest Physicians.