Contraction Myocardial

IJCS

Case Report

Left Ventricular Dyssynchrony in a Patient with Normal Perfusion and Stress-Induced Left Bundle Branch Block

Maria Gazzilli et al. Rexhep Durmo Claudio Tinoco Mesquita Raffaele Giubbini

Introduction

Left bundle branch block (LBBB) is an electrocardiographic abnormality that occurs in approximately 0.5-1.1% of all patients who undergo exercise testing. The diagnosis of complete LBBB is made with the 12-lead electrocardiogram (ECG) if all the following criteria are met: conduction originating above the atrioventricular node; a QRS duration of 120 milliseconds or more; predominantly upright complexes with broad-slurred R waves in leads I, V5, and V6; and a QS or RS pattern in V1 with a normal intrinsicoid deflection of 35 milliseconds.

The precise mechanism and the prognostic significance of Exercise Induced-LBBB (EI-LBBB) remains unclear. EI-LBBB can be associated with coronary artery disease (CAD). However, in a group of patients, coronary arteries are normal. Several authors have attributed EI-LBBB to functional alterations of the conduction system mediated by autonomic influences in non-ischemic cases. We report a case of a 72-year-old female patient who developed LBBB during exercise stress testing and showed reversible abnormalities in cardiac contraction.

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Left Ventricular Dyssynchrony in a Patient with Normal Perfusion and Stress-Induced Left Bundle Branch Block

Introduction

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