This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cohen, H. C. Articles by Pick, A. Search for Related Content PubMed PubMed Citation Articles by Cohen, H. C. Articles by Pick, A.

Circulation, Vol 55, 242-246, Copyright © 1977 by American Heart Association

ARTICLES

Tachycardia and bradycardia-dependent bundle branch block alternans: clinical observations

HC Cohen, I D'Cruz, ER Arbel, R Langendorf and A Pick

Eleven patients with tachycardia-dependent, bradycardia-dependent, or "pseudobradycardia-dependent" bundle branch block (BBB) alternans were studied. This classification is based on the following criteria: 1) When alternans is initiated by a sudden acceleration in ventricular rate, or it appears with aberration of the second beat after a pause, the alternans is tachycardia-dependent and results from a 2:1 bidirectional block in the affected bundle branch. 2) When alternans begins with the aberrant complex terminating a pause it is bradycardia- dependent; such an alternans results from alternating bundle branch cycle lengths and refractoriness, possibly produced by alternating transseptal retrograde penetration of the affected bundle branch. 3) In cases referred to as "pseudobradycardia-dependent BBB" alternans, a change from alternans to persiscardia-dependent BBB" alternans, a change from alternans to persistent BBB occurs as the cycle lengthens; however, the disappearance of BBB with further increase of the cycle length proves the tachycardia-dependence of the conduction defect.

This article has been cited by other articles:

				N. Kanemoto Complete Right Bundle Branch Block (CRBBB) with Three Different Mean Frontal Plane QRS Axes A Case Report Angiology, July 1, 1988; 39(7): 631 - 634. [Abstract] [PDF]