Open AccessTachycardia‐dependent right bundle‐branch block with supernormal conduction
Author(s) -
Katoh Takakazu,
Kinoshita Shinji,
Oyama Yohtaro,
Tsujimura Yoshinori,
Sasaki Yoshihiko
Publication year - 2000
Publication title -
clinical cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.263
H-Index - 72
eISSN - 1932-8737
pISSN - 0160-9289
DOI - 10.1002/clc.4960230121
Subject(s) - medicine , right bundle branch block , atrial flutter , tachycardia , refractory period , cardiology , bundle , left bundle branch block , qrs complex , bundle branch block , impulse (physics) , electrocardiography , anatomy , atrial fibrillation , heart failure , physics , materials science , quantum mechanics , composite material
Abstract This paper reports the case of a 76‐year‐old man in whom atrial flutter with varying atrioventricular block and intermittent right bundle‐branch block was found. This is the first report on tachycardia‐dependent right bundle‐branch block associated with supernormal conduction in a case of atrial flutter. When an impulse is conducted to the ventricles beyond 0.72 s after a QRS complex of right bundle‐branch block configuration, the impulse falls after the abnormally long effective refractory period of the right bundle branch and passes through the right bundle branch. When the conducted impulse occurs within 0.72 s after a QRS complex of right bundle‐branch block configuration, the impulse usually falls in the refractory period and is blocked in the right bundle branch; however, only when the impulse occurs 0.48 or 0.49 s after that does it fall in the supernormal period and passes through the right bundle branch. The findings in the present report strengthen our previous suggestion that the presence of supernormal conduction plays an important role in the initiation of reentrant ventricular tachycardia.