Intraventricular trifascicular blocks. Review of the literature and classification

Rosenbaum, Mauricio B.; Elizari, Marcelo V.; Lázzari, Julio O.; Nau, Gerardo; Levi, Raúl J.; Halpern, M. Susana

doi:10.1016/0002-8703(69)90478-5

Cited by 131 publications

(13 citation statements)

References 12 publications

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“…Those patients with a mean frontal plane QRS axis of -45' or more leftward, and initial right inferior vector with r waves in leads II, III, aVF, and with a Q wave in lead aVL, followed by a left superior vector, were included in this subgroup of patients with left anterior hemiblock. Those patients with left axis deviation with QS complexes and with no terminal R waves in leads II, III, and aVF were accepted as having a combination of an old inferior myocardial infarction and left anterior hemiblock (Rosenbaum et al, 1969a(Rosenbaum et al, , 1970Marriott and Hogan, 1970;Castellanos et al, 1971;Benchimol et al, 1972;Rosenbaum et al, 1972;Schamroth, 1975). Those with left axis deviation but not meeting the criteria for left anterior hemiblock were included in the second subgroup.…”

Section: Methodsmentioning

confidence: 99%

Prognostic significance of isolated left anterior hemiblock and left axis deviation in the course of acute myocardial infarction.

Büyüköztürk¹,

Korkut²,

Meriç³

et al. 1977

Heart

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In 700 patients with acute myocardial infarction admitted to the intensive coronary care unit of our hospital, the incidence and significance of left anterior hemiblock and left axis deviation has been studied in the acute phase of disease. In 102 (14-6%) of the 700 patients, isolated left axis deviation (mean QRS axis -45O) was found and 69 of them (9. 9%) met the criteria of left anterior hemiblock. Of the 69 patients with left anterior hemiblock, 61 had acute anterior myocardial infarction, 5 had inferior infarction, and 3 had subendocardial infarction. The left anterior hemiblock was transient in 5 patients, but persisted in 64. All patients with and without isolated left anterior hemiblock and left axis deviation were compared statistically with reference to mortality rate and the incidence of arrythmias; no significant difference was noted. However, in patients over the age of 65 and also in those with hypertension, the incidence of left axis deviation was significantly higher (P<0 05 and P<0-001, respectively).It was concluded that isolated left anterior hemiblock and left axis deviation occurring in the course of acute myocardial infarction had no influence on the prognosis of acute myocardial infarction.

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Section: Methodsmentioning

confidence: 99%

Prognostic significance of isolated left anterior hemiblock and left axis deviation in the course of acute myocardial infarction.

Büyüköztürk¹,

Korkut²,

Meriç³

et al. 1977

Heart

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“…The excellent work of Rosenbaum convinced me that conduction system abnormalities were more complex than the terms left and right bundle-branch block would have us believe. 2,3 These concepts evolved deductively over a period of many years as I correlated the abnormalities seen in the electrocardiogram with other clinical data, including echocardiography and coronary arteriography.…”

Section: The Evolution Of the New Terminologymentioning

confidence: 99%

A new terminology for describing left and right ventricular conduction abnormalities

Hurst

2003

Clinical Cardiology

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Summary:The words we use to describe a medical condition should match our knowledge of it. Unfortunately, at times, the words we used long ago persist after new knowledge of the subject has become apparent; so it is with left and right ventricular conduction system abnormalities. The words left or right bundle-branch block no longer reflect our knowledge of the condition. Accordingly, this essay describes a new terminology that more accurately describes the numerous abnormalities that compose left and right ventricular conduction system block as well as their numerous subsets. A brief account of the cardiac conditions associated with the conduction defects is also presented.

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“…Rosenbaum et al (1969b) reported several cases where the SIQIII pattern occurred concomitantly with intermittent left posterior fascicular block. In fact, our criteria A and B, as previously described, correspond respectively to the existence of a Q wave in lead III and an S wave in lead I.…”

Section: Presumptive Criteria Of Left Posterior Fascicular Blockmentioning

confidence: 99%

Spatial Frank vectorcardiogram in left posterior fascicular block. Criteria and correlation with clinical and electrocardiographic data.

Brohet¹,

Arnaud²

1977

Heart

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Computer processing of spatial QRS parameters (Frank vectorcardiogram) was used to study left posterior fascicular block. The best set of vectorcardiographic criteria was sought in order to characterise the classic pattern of left posterior fascicular block. Using these criteria, 18 cases were selected from a group of 4600 patients and 340 healthy subjects; isolated left posterior fascicular block was seen in 10 cases, and was associated with right bundle-branch block in 8 cases. It is shown that some external factors can influence the aspect of the spatial QRS loop in left posterior fascicular block: cardiomegaly tends to produce a superior displacement of the main QRS forces: right bundle-branch block enhances the superior displacement of the initial forces and shifts the main QRS forces more anteriorly and to the right. The 'masquerading effect' of the left posterior fascicular block on a concomitant inferior myocardial infarct was also shown. The most important diagnostic feature was the opposite direction of the initial forces (left anterosuperior) and the maximal vector (right postero-inferior): the angle between these two vectors averaged 152 degrees. Other criteria, such as the direction of rotation or the axis of the frontal loop, the vertical direction of the spatial loop, the presence of a Q wave in leads II, III, and aVF of the electrocardiogram, are not mandatory for the diagnosis of left posterior fascicular block.

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Intraventricular trifascicular blocks. Review of the literature and classification

Cited by 131 publications

References 12 publications

Prognostic significance of isolated left anterior hemiblock and left axis deviation in the course of acute myocardial infarction.

Prognostic significance of isolated left anterior hemiblock and left axis deviation in the course of acute myocardial infarction.

A new terminology for describing left and right ventricular conduction abnormalities

Spatial Frank vectorcardiogram in left posterior fascicular block. Criteria and correlation with clinical and electrocardiographic data.

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