M-mode echocardiography in left bundle branch block: Significance of frontal plane QRS axis

Boris Strasberg, Stuart Rich*, Wilfred Lam, Steven Swiryn, Robert Bauernfeind, Kenneth M. Rosen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

7 Scopus citations

Abstract

M-mode echocardiograms were obtained in 48 patients with complete left bundle branch block (LBBB). Of these 48 patients, 28 had LBBB with normal frontal plane QRS axis (-20° to +90°, mean ± SD 18° ± 34°), and 20 had LBBB with a left axis deviation (LAD) (-30° to -60°, mean ± SD -48° ± 11°). In the group with LBBB and normal axis, 25 patients had typical early systolic posterior septal motion characteristic of LBBB. Septal motion following early posterior septal motion (through the ejection period) was posterior in 24 patients (86%), anterior (paradoxical) in 2 (7%), and flat in 2 (7%). In the group with LBBB and LAD, 16 patients had the typical early systolic posterior septal motion; subsequent septal motion was posterior in 3 (15%), anterior (paradoxical) in 13 (65%), and flat in 4 (20%). Patients with LBBB and normal axis had a higher frequency of posterior septal motion, and patients with LAD had a higher frequency of anterior septal motion (p < 0.001). The correlation of abnormal axis and paradoxical septal motion may be explained by the activation pattern producing LAD or by a septal disease process producing both abnormalities of axis and abnormal septal motion.

Original languageEnglish (US)
Pages (from-to)775-779
Number of pages5
JournalAmerican heart journal
Volume104
Issue number4 PART 1
DOIs
StatePublished - Oct 1982

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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