This case report provides clinical evidence supporting slow Phase 4 depolarization of latent pacemaker cells as a mechanism for conduction abnormalities in bradycardia-dependent left bundle branch block.
Supports bradycardia-dependent LBBB mechanism; hypothesis-generating and should not yet change practice.
This report describes tachycardia- and bradycardia-dependent left bundle branch block in a patient who exhibited normal intraventricular conduction with impulses intermediate in timing. During bradycardia, longer cycles were associated with increasing degrees of incomplete left bundle branch block. These clinical observations support the existence of slow Phase 4 depolarization of latent pacemaker cells as one of the mechanisms for abnormalities of conduction.
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Barold et al. (1973) studied this question.
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