We reviewed electrocardiograms of 23 patients with intermittent left bundle-branch block. A characteristic electrocardiographic pattern consisting of right and midprecordial deep symmetrical T-wave inversions was detected during normal conduction in 19 of the 23. Of the 7 patients who had cardiac catheterization, only 2 had findings suggestive of organic heart disease and only 1 had significant obstructive coronary disease. Thus we conclude that patients with intermittent left bundle-branch block frequently have T-wave inversions in right and midprecordial leads during normal conduction that do not necessarily reflect coronary disease. These T-wave changes are similar to those after termination of chronic right ventricular pacing (left bundle-branch pattern), suggesting that both patterns of abnormal ventricular activation can produce abnormal repolarization when activation returns to normal.
ASJC Scopus subject areas
- Internal Medicine