By Vasken Dilsizian, Gerald M Pohost
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Extra resources for Cardiac CT, PET and MR
On the third beat, conduction either blocks or slows severely in the right bundle branch, resulting in prolongation of the HV interval to 120 ms and right bundle branch block morphology. If the left bundle branch were actually blocked, then concurrent block in the right bundle branch would have resulted in AV block. Based on the prolongation of the HV interval and change in QRS morphologies from the 1st to 3rd complexes, we can conclude that left bundle branch conduction is delayed rather than blocked in the 1st complex.
F Question A 35-year-old man with GERD and nephrolithiasis underwent electrophysiologic evaluation because of rapid palpitations that occurred while the patient was power lifting. What is the most likely diagnosis? F 27 28 Essential Concepts of Electrophysiology and Pacing through Case Studies Answer The correct answer is A. The figure shows a regular wide complex tachycardia with right bundle branch block morphology. Its morphology is consistent with a ventricular origin, and the absence of His bundle potentials preceding each QRS excludes SVT with aberration.
3. Gupta PK, Lichstein E, Chadda KD. Chronic His bundle block: clinical, electrocardiographic, electrophysiological, and follow-up studies in 16 patients. Br Heart J. 1976;38:1343–1349. K Question A 54-year-old man with hypertension presents with fatigue and lightheadedness. Which of the following reflect what is observed in the following figure? K 47 48 Essential Concepts of Electrophysiology and Pacing through Case Studies Answer The correct answer is C. The figure shows sinus rhythm with intranodal AV block interrupted by 2:1 manifest preexcitation over a posteroseptal AP.
Cardiac CT, PET and MR by Vasken Dilsizian, Gerald M Pohost