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    Bundle Branch Block 2

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    Jiehah Rudy
    This document discusses bundle branch blocks and fascicular blocks seen on electrocardiograms. It describes the characteristics of left bundle branch block (LBBB) including a QRS duration greater than 120 ms and broad R waves in V5-V6. It also discusses the challenges of diagnosing myocardial infarction in the setting of LBBB. Right bundle branch block (RBBB) is also described including terminal S waves in the lateral leads and a QRS duration greater than 120 ms. Complete and incomplete forms of RBBB are distinguished based on QRS width. Fascicular blocks are noted to change the QRS axis without widening the complex.

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    Bundle Branch Block 2

    Uploaded by

    Jiehah Rudy
    19 views38 pages
    This document discusses bundle branch blocks and fascicular blocks seen on electrocardiograms. It describes the characteristics of left bundle branch block (LBBB) including a QRS duration greater than 120 ms and broad R waves in V5-V6. It also discusses the challenges of diagnosing myocardial infarction in the setting of LBBB. Right bundle branch block (RBBB) is also described including terminal S waves in the lateral leads and a QRS duration greater than 120 ms. Complete and incomplete forms of RBBB are distinguished based on QRS width. Fascicular blocks are noted to change the QRS axis without widening the complex.

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    This document discusses bundle branch blocks and fascicular blocks seen on electrocardiograms. It describes the characteristics of left bundle branch block (LBBB) including a QRS duration greater than 120 ms and broad R waves in V5-V6. It also discusses the challenges of diagnosing myocardial infarction in the setting of LBBB. Right bundle branch block (RBBB) is also described including terminal S waves in the lateral leads and a QRS duration greater than 120 ms. Complete and incomplete forms of RBBB are distinguished based on QRS width. Fascicular blocks are noted to change the QRS axis without widening the complex.

    Copyright:

    © All Rights Reserved
    Download as PPT, PDF, TXT or read online from Scribd
    Download as ppt, pdf, or txt
    19 views38 pages

    Bundle Branch Block 2

    Uploaded by

    Jiehah Rudy
    This document discusses bundle branch blocks and fascicular blocks seen on electrocardiograms. It describes the characteristics of left bundle branch block (LBBB) including a QRS duration greater than 120 ms and broad R waves in V5-V6. It also discusses the challenges of diagnosing myocardial infarction in the setting of LBBB. Right bundle branch block (RBBB) is also described including terminal S waves in the lateral leads and a QRS duration greater than 120 ms. Complete and incomplete forms of RBBB are distinguished based on QRS width. Fascicular blocks are noted to change the QRS axis without widening the complex.

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    You are on page 1of 38

    ELECTROCARDIOGRAM

    YCT20104
    BUNDLE BRANCH BLOCK

    HAMDAN IBRAHIM
    LBBB: RV contracts, then LV contracts
     QRS > 120 msec

     V5-V6: Broad R wave

     I + aVL: Absence of Q wave


     Patients with a suspected myocardial infarction (MI) in the
    setting of a left bundle branch block (LBBB) present a
    unique diagnostic and therapeutic challenge to the
    clinician.
     A diagnosis of MI with electrocardiogram (ECG) is
    especially difficult in the setting of LBBB because of the
    characteristic ECG changes caused by altered ventricular
    •In 1996, Elena B Sgarbossa first described criteria to assist
    depolarization.
    clinicians to diagnose infarction in the setting of LBBB
    RBBB: Left ventricle contracts, then right ventricle contracts

     QRS > 120 msec

     V1-V2: RSR’

     Lateral leads: Deep terminal S


    wave
    RBBB

     Three phases:

    -Septal depolarization.
    -Left ventricular depolarization.
    -Delayed stimulation of the right ventricle.
    septal depolarization delayed right
    depolarization of LV produces ventricular
    produces a small an S in V1 and depolarization
    septal r wave in an R in V6 produces a wide R
    V1 and a small wave in V1 and a wide
    septal q wave in S wave in V6
    V6
    COMPLETE AND INCOMPLETE
    RBBB

     Depends on the width of the QRS complex:

    Complete RBBB is defined by a QRS that is 0.12 second or


    more with an rSR in lead V1 and a qRS in lead V6.
    Incomplete RBBB shows the same QRS patterns, but its
    duration is between 0.1 and 0.12 second
    EKG Changes:

     Hemiblock (unlike a full LBBB or RBBB) does not widen the QRS
    complex.
     Main effect is a change in the QRS axis:

     Left anterior fascicular block results in marked left axis deviation


     Left posterior fascicular block produces marked right axis deviation
    THANK YOU

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