Key result
Electrophysiologic study of a patient with alternating bundle branch block revealed a combination of longitudinal dissociation in the His bundle and the gap phenomenon at the intra-Hisian block portion.
Case Report (n=1)
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This case report demonstrates that alternating bundle branch block can be explained by a combination of longitudinal dissociation in the His bundle and the gap phenomenon at the intra-Hisian block portion.
We describe a 66-year-old woman who had an alternating bundle branch block consisting of coexisting occurrence of right bundle branch block (RBBB) and left bundle branch block (LBBB) combined with Mobitz type II atrioventricular block (AVB). A prolonged PQ interval was associated with the RBBB pattern whereas it was not apparent in the LBBB pattern. Electrophysiologic study revealed that the LBBB pattern was combined with a double His bundle potential. On the other hand, the RBBB pattern was combined with a markedly prolonged HV interval with a low voltage monophasic His bundle potential, which we speculated was the former part of the split His bundle potential seen during the LBBB pattern. A combination of the longitudinal dissociation in the His bundle and the gap phenomenon at the intra-Hisian block portion may account for this observation.
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Ogura et al. (2005) conducted a case report in Alternating bundle branch block (n=1). Alternating bundle branch block was evaluated. Electrophysiologic study of a patient with alternating bundle branch block revealed a combination of longitudinal dissociation in the His bundle and the gap phenomenon at the intra-Hisian block portion.
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