Alternating Complete & Incomplete LBBB

Report:

Sinus rhythm 67/min

Alternating complete & incomplete left bundle branch block

Probable LVH

Comment:

The complete LBBB, if the patient lives long enough, will probably become permanent. At this stage it is still rate-dependent: slowing the sinus rate to 58/min abolished it (Fig 75a).

LVH is a reasonable assumption in this case: 90% of patients with incomplete LBBB have it. Whether RV6 > RV5 is also a criterion in the setting of the conduction defect is unknown. I think it’s likely.

Fig 75a.

Fig 76. 69 year old lady with chest pain.

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Ventricular Conduction

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