Key result
Combined electrophysiologic and radionuclide investigations revealed a right-sided accessory pathway and complex conduction abnormalities in a patient with WPW type B and LBBB.
Case Report (n=1)
Combined electrophysiologic and radionuclide investigations are useful to disclose complex conduction abnormalities and their mechanical correlates in rare cases of coinciding LBBB and WPW type B.
Coinciding left bundle-branch block and Wolff-Parkinson-White syndrome type B, a very rare electrocardiographic occurrence, was found in a patient with dilated cardiomyopathy. Electrophysiologic study revealed eccentric retrograde atrial activation during ventricular pacing, suggesting right-sided accessory pathway. At programmed atrial pacing, effective refractory period of the accessory pathway was 310 ms; at shorter pacing coupling intervals, normal atrioventricular conduction with left bundle-branch block was seen. Left bundle-branch block was seen also with His bundle pacing. Radionuclide phase imaging demonstrated right ventricular phase advance and left ventricular phase delay; both right and left ventricular phase images revealed broad phase distribution histograms. Combined electrophysiologic and radionuclide investigations are useful to disclose complex conduction abnormalities and their mechanical correlates.
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Rakovec et al. (1985) conducted a case report in Dilated cardiomyopathy with Wolff-Parkinson-White syndrome type B and left bundle-branch block (n=1). Electrophysiologic and radionuclide study was evaluated on Electrophysiologic and radionuclide characteristics. Combined electrophysiologic and radionuclide investigations revealed a right-sided accessory pathway and complex conduction abnormalities in a patient with WPW type B and LBBB.
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