Does standard echocardiography identify specific septal motion abnormalities in patients with left bundle branch block?
Left bundle branch block is associated with a specific, dynamic posterior motion of the interventricular septum on echocardiography that occurs within 0.04 seconds of QRS onset.
Seventeen patients with left bundle branch block were studied using standard echocardiographic techniques employing a strip chart recorder. All 17 patients were found to have specific echocardiographic findings of abnormal septal motion uniquely different from previously described forms found in volume overload states of the right ventricle as well as coronary artery disease. The specific echocardiographic abnormality demonstrated in left bundle branch block is a very dynamic posterior motion of the interventricular septum occurring within 0.04 seconds of the onset of the QRS and preceding the anterior motion of the posterior left ventricular wall during ventricular ejection. This type of septal motion is not seen in the other forms of abnormal septal motion and appears to be specific for left bundle branch block.
Dillon et al. (1974) studied this question.