This case report highlights a rare electrocardiographic phenomenon of gradual, cycle-length-dependent transition between normal conduction and complete left bundle branch block during atrial fibrillation.
Rare pattern warrants ECG recognition in AF; hypothesis-generating for aberrancy mechanisms and leaves open clinical relevance.
A case of 70-year-old woman with ischemic heart disease is presented. The electrocardiogram showed atrial fibrillation and a tachycardia-dependent, left bundle branch block. A number of intermediate QRS patterns from normal intraventricular conduction to complete left bundle branch block were seen, and the transition was gradual. Increasing grades of aberrance were seen following a shorter preceding cycle length.
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Yoshikazu Suzuki (1982) studied this question.
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