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(Chest. 1972;62:673-677.)
© 1972 American College of Chest Physicians

Phase-3 and Phase-4 Intermittent Left Anterior Hemiblock

Report of First Case in the Literature

Marcelo V. Elizari M.D.1; Julio O. Lázzari M.D.2; and Mauricio B. Rosenbaum M.D.3

1 Chief, Department of Electrocardiography, Argerich Hospital
2 Staff, Department of Electrocardiography, Agerich Hospital
3 Chief, Service of Cardiology, Salaberry Hospital

A 33-year-old man developed left anterior hemiblock (LAH), which was shown to occur both at rapid and slow rates, with an intermediate normal conduction range. LAH occurred at R-R intervals of 1.10 second or less; normal conduction between 1.10 and 1.60 second; and LAH again from 1.60 onwards. The tachycardia-dependent LAH was related to a prolongation of recovery in the anterior division of the left bundle branch and was termed "phase-3 block;" the bradycardia-dependent LAH was related to hypopolarization plus spontaneous diastolic depolarization and was termed "phase-4 block." Progressively decreasing degrees of LAH were observed at the transition between phase-3 block and normal conduction; and progressively increasing degrees of LAH occurred at the much wider transition between normal conduction and phase-4 block.






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Copyright © 1972 by the American College of Chest Physicians.