What does this research mean for the field?

Complete right bundle-branch block with right axis deviation in the absence of right ventricular hypertrophy indicates extensive conducting system involvement (often progressing to trifascicular block), requires intracardiac pacing, and carries a poor prognosis. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To evaluate the clinical significance, electrophysiological mechanisms, and prognosis of complete right bundle-branch block accompanied by right axis deviation in the absence of right ventricular hypertrophy.

January 1, 1970HeartOpen Access

Significance of complete right bundle-branch block with right axis deviation in absence of right ventricular hypertrophy.

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Population

9 patients with complete right bundle-branch block and right axis deviation who did not have right…

Design

Case_series

Authors

ACA CastellanosNational Tsing Hua University OMOrlando MaytinUniversity of Miami AAAzucena G. ArcebalAmerican Heart Association

Discussion

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Implication

May warrant pacing evaluation in bifascicular block variants with guarded prognosis; hypothesis-generating for conduction disease extent.

Key Points

To evaluate the clinical significance, electrophysiological mechanisms, and prognosis of complete right bundle-branch block accompanied by right axis deviation in the absence of right ventricular hypertrophy.
Analyzed clinical and electrocardiographic records of 9 patients (4 with chronic block and 5 with acute myocardial infarction) presenting with complete right bundle-branch block and right axis deviation.
Excluded patients with right ventricular hypertrophy, pulmonary disease, or extensive lateral myocardial infarction to isolate specific intraventricular conduction system defects.
The conduction pattern frequently alternated with complete left bundle-branch block, isolated right bundle-branch block, and right bundle-branch block with superior division block.
Type II Mobitz block developed in 8 of 9 patients from either normal or prolonged PR intervals, indicating simultaneous involvement of the right bundle and both divisions of the left bundle (trifascicular block).
All 9 patients (100%) required intracardiac pacing, and overall prognosis was poor due to extensive anatomical damage across the ventricular conduction system.

Structured PICO

Population

9 patients with complete right bundle-branch block and right axis deviation who did not have right ventricular hypertrophy, pulmonary disease, or extensive lateral myocardial infarction (4 with chronic block, 5 with acute myocardial infarction).

Outcome

Clinical course and electrophysiological mechanisms

Complete right bundle-branch block with right axis deviation in the absence of right ventricular hypertrophy indicates extensive conduction system disease requiring pacing and carrying a poor prognosis.

Cite This Study

Castellanos et al. (1970) studied this question.

synapsesocial.com/papers/6a1c07e04ebd09f3dfa95bc1 https://doi.org/10.1136/hrt.32.1.85

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Significance of complete right bundle-branch block with right axis deviation in absence of right ventricular hypertrophy.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Significance of complete right bundle-branch block with right axis deviation in absence of right ventricular hypertrophy.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

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