Circulation, Vol 55, 49-54, Copyright © 1977 by American Heart Association
J Sugenoya, S Sugiyama, M Wada, N Niimi and H Oguri
Right bundle branch block (RBBB) was produced in five dogs by incising the
main right bundle branch. Body surface isopotential maps of each of these
dogs were obtained from 85 thoracic electrocardiograms using a
mini-computer technique. In addition, the epicardial activaton process was
obtained from the same dog, and were correlated with the map pattern.
Following the incision, the following characteristic changes in the map
pattern occurred: The ventricular activation was prolonged in RBBB as
compared with normal. During the early stage of ventricular excitation, the
maximum was shifted leftward due to the activation wavefronts in the left
ventricle in contrast to the double septal activation in the control. A
localized lower potential area (a concavity) which appears in the middle
stage of activation within the anterior positivity as an initial
representation of breakthrough was also shifted left-and-downward and
delayed in appearance. The sudden change in the potential distribution
subsequently observed occurred quite differently. The terminal excitation
was characterized by the maximum occurring over the right chest in RBBB in
contrast to the left chest in control. These changes in the pattern of the
potential distribution were compatible with the changes in the ventricular
excitation process. This result may be applied to human RBBB map
interpretation.
ARTICLES
Body surface potential distribution following the production of right bundle branch block in dogs. Effects of breakthrough and right ventricular excitation on the body surface potentials
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