A 77-year-old female patient with sinus bradycardia and left bundle branch block was implanted with a DDD Biotronik Kairos DR pacemaker in 1999, then a replacement for depleted battery was performed in 2007 (Biotronik Axios DR). During our regularly scheduled follow-ups, we found the atrial and ventricular sensing/pacing function to be satisfactory: P: 3.6 mV, R: 9.9 mV, atrial threshold: 0.7 V...

The electrocardiographic features associated with acute myocardial infarction (AMI) are often easily recognised. However, interpretation is made more difficult in the presence of confounding patterns such as a left bundle branch block (LBBB). This may result in missed cases which may otherwise have benefited from acute revascularisation therapy. Though not straightforward, the diagnosis of AMI ...

Gaps" in bundle-branch conduction were observed in three patients using the combined technic of premature atrial stimulation and His bundle recordings. In type I gap a complete LBBB pattern disappeared at shorter coupling intervals because the premature atrial impulses encountered enough delay at the A-V node to reach the left bundle branch after the end of its effective refractory period. When...

V ENTRICULAR extrasystoles can occur anywhere in the cardiac cycle. When they occur toward the end of diastole they may be synchronous with the next conducted impulse resulting in a fusion complex. We report a case of left bundle-branch block associated with end-diastolic ventricular extra-systoles that occur in bigeminal rhythm; this results in fusion complexes that apparently normalize the bu...

Alternating bundle branch block (ABBB) is a less commonly encountered phenomenon with the advent of re-perfusion therapy for acute myocardial infarction. ECGs simulating the appearance of an ABBB need to be carefully analysed. We present an ECG showing a baseline Left Bundle Branch Block(LBBB) progressing to a high grade AV block with escape complexes having a Right Bundle Branch Block (RBBB) m...

OBJECTIVES Perfusion abnormalities are frequently seen in Single Photon Emission Computed Tomography (SPECT) when a left bundle branch block is present. A few studies have shown decreased coronary flow reserve in the left anterior descending territory, regardless of the presence of coronary artery disease. OBJECTIVE We sought to investigate rubidium-82 (82Rb) positron emission tomography imag...