Etiology of right bundle-branch block pattern after surgical closure of ventricular-septal defects

Okoroma, E. O.; Guller, Barbara; Maloney, James D.; Weidman, William H.

doi:10.1016/0002-8703(75)90251-3

Cited by 60 publications

(13 citation statements)

References 11 publications

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“…The most plausible explanation for RBBB-associated anteroseptal Q wave formation is that septal (median) fascicular block (SFB) might be concomitantly involved in the genesis of this ECG phenomenon [28, 29, 30, 31]. However, the precise mechanism by which SFB may contribute to a false-positive diagnosis of Q wave MI, particularly in the presence of RBBB, has not been identified.…”

Section: Impact Of the Level Of Rbbb On Transseptal Conduction And Itmentioning

confidence: 99%

“…However, the precise mechanism by which SFB may contribute to a false-positive diagnosis of Q wave MI, particularly in the presence of RBBB, has not been identified. Consensus on ECG criteria for the SFB is also lacking: some investigators have attributed SFB to the apparent loss of anterior forces resulting in development of transient Q waves in leads V 1 –V 2 [10, 28, 29, 32], while others have linked SFB with the apparent increase of anterior forces in the horizontal but not the frontal plane (a tall initial R wave in the right chest leads without a change in QRS axis) [31, 33]. Still others [34, 35, 36]believe that this conduction block, depending on the site of insertion of the septal, anterior, and posterior fascicles, could produce an apparent loss or gain of anterior forces.…”

Section: Impact Of the Level Of Rbbb On Transseptal Conduction And Itmentioning

confidence: 99%

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False-Negative and False-Positive ECG Diagnoses of Q Wave Myocardial Infarction in the Presence of Right Bundle-Branch Block

Gussak

Wright²,

Bjerregaard

et al. 2000

Cardiology

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Right bundle-branch block (RBBB) has not traditionally been seen as an obstacle to ECG diagnosis of Q wave myocardial infarction (MI) – in clinical electrocardiography and vectorcardiography – because this conduction disturbance is not believed to cause significant alterations in the spatial orientation of initial excitation wavefronts. In the era of large-scale clinical trials, however, where serial ECG analysis is among the major diagnostic tools in MI classification, both false-positive and false-negative diagnoses of MI in the presence of RBBB have become increasingly evident. Because of the limited detectability of Q wave MI by ECG in the presence of RBBB, the electrocardiographic finding of Q wave MI should not be regarded as an independent diagnostic tool. It is best to utilize independent corroboration to establish the diagnosis of transmural infarction when RBBB is present. Further investigations are warranted to better delineate sensitivity, specificity, and predictive value of Q wave MI in the presence of RBBB.

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Section: Impact Of the Level Of Rbbb On Transseptal Conduction And Itmentioning

confidence: 99%

Section: Impact Of the Level Of Rbbb On Transseptal Conduction And Itmentioning

confidence: 99%

False-Negative and False-Positive ECG Diagnoses of Q Wave Myocardial Infarction in the Presence of Right Bundle-Branch Block

Gussak

Wright²,

Bjerregaard

et al. 2000

Cardiology

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show abstract

“…5,7,8) Right bundle branch block, which may be associated with diastolic dysfunction in late follow-up, remains another common conduction disturbance with a reported prevalence of 20%-62%. 12,19,20,21) Both are unequivocally linked to the surgical maneuvers. Precise identification of the conduction bundle including the penetrating bundle, non-branching bundle, and right bundle branch is of surgical importance.…”

Section: Discussionmentioning

confidence: 99%

Mattress Stitch—A Modified Shallow Stitching in the Surgical Closure of Large Perimembranous Ventricular Septal Defect in Infants

Shi

Chen

Sun

et al. 2015

ATCS

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“…Subramanian (1976) noted that there was an incidence of postoperative complete -right bundle-branch block in 44-4 per cent of patients who underwent surgery by the transatrial approach. Okoroma et al (1975) found an incidence of 44 per cent in a similar group.…”

mentioning

confidence: 80%

“…Conduction disturbances after surgical correction of ventricular septal defects have been well documented (Titus et al, 1963;Kulbertus et al, 1969;Downing et al, 1972;Wolff et al, 1970;Godman et al, 1974;Okoroma et al, 1975;Subramanian, 1976;Sigmann et al, 1977). Surgical technique has been implicated.…”

mentioning

confidence: 99%

Conduction disturbances after surgical correction of ventricular septal defect by the atrial approach.

Hobbins¹,

Izukawa²,

Radford³

et al. 1979

Heart

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Conduction disturbances have been documented after correction of ventricular septal defects by the ventricular route. Recently, repair of the ventricular septal defect has been through the right atrium to overcome damage to the conduction system and a right ventriculotomy. Thirty-nine children with ventricular septal defects under the age of 5 years were operated upon by the atrial route (group 1). The incidence of conduction disturbances in this group was compared with that occurring in 19 children of comparable age with a ventricular septal defect repaired via a right ventriculotomy (group 2). Complete right bundle-branch block developed in 13 of 39 children (33.3%) in group 1, compared with 15 of 19 children (78.9%) in group 2. This was a statistically significant reduction in complete right bundle-branch block in group 1. The incidence of left axis deviation occurring with complete right bundle-branch block was similarly statistically reduced. Transient complete heart block and arrhythmias were not statistically different in the two groups. The atrial approach to the repair of the ventricular septal defect significantly reduced the incidence of complete right bundle-branch block alone and occurring with left axis deviation.

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Etiology of right bundle-branch block pattern after surgical closure of ventricular-septal defects

Cited by 60 publications

References 11 publications

False-Negative and False-Positive ECG Diagnoses of Q Wave Myocardial Infarction in the Presence of Right Bundle-Branch Block

False-Negative and False-Positive ECG Diagnoses of Q Wave Myocardial Infarction in the Presence of Right Bundle-Branch Block

Mattress Stitch—A Modified Shallow Stitching in the Surgical Closure of Large Perimembranous Ventricular Septal Defect in Infants

Conduction disturbances after surgical correction of ventricular septal defect by the atrial approach.

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