Masquerading and Left BBB: BBBB
Report:
Atrial fibrillation with rapid ventricular response 150/min
Right bundle branch block
Left anterior hemiblock
Left bundle branch block
Bilateral bundle branch block.
Nonspecific ST/T changes
Comment:
In this case one can diagnose BBBB directly from the original trace.
In the limb leads there is hardly any difference between RBBB/LAHB complexes and those with LBBB (as seen from the rhythm strip on V1 below). This is the standard masquerading bundle branch block: RBBB and a very high grade of LAHB. Maybe it would also be a precordial masquerade with V7 and V8 taken, since the two blocks look remarkably similar in V6.
In this patient RBBB conduction predominated at faster rates and LBBB at slower rates, including sinus rhythm. Below (Fig 41a) is another fast trace with the rarely seen alternating BBB at the end.
Fig 41a.
Fig 42. 54 year old man with chronic renal failure.
If you have any suggestions for or feedback on this report, please let us know.
Hi, can we chat about some terms and conditions?
The library and its records are licensed under the Creative Commons Attribution 4.0 International license.
You are free to:
- Share — copy and redistribute the material in any medium or format for any purpose, even commercially.
- Adapt — remix, transform, and build upon the material for any purpose, even commercially.
- The licensor cannot revoke these freedoms as long as you follow the license terms.
Under the following terms:
- Attribution — You must give appropriate credit , provide a link to the license, and indicate if changes were made . You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.
- No additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.
By clicking agree below, you are agreeing to adhere to CC BY 4.0.