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ISSN: 2637-6679

Research and Reviews on Healthcare: Open Access Journal

Case Report(ISSN: 2637-6679)

Relation of QRS Vector and Transverse Ring in Left Bundle Branch Block: Case Report Volume 6 - Issue 2

Hassa Iftikhar1*, Ya Li2 and Akanganyira Kasenene3

  • 1Department of Cardiology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (HUST). Wuhan, Hubei, PR China
  • 2Department of Cardiology, Zhongnan Hospital of Wuhan University, Wuhan University, Wuhan, Hubei, PR China
  • 3Department of Imaging and Nuclear Medicine, Zhejiang University, Hangzhou, PR China

Received: May 5, 2021   Published: May 20, 2021

Corresponding author: Hassa Iftikhar, Department of Cardiology, Tongji Hospital, Tongji Medical College of Huazhong University of Science and Technology (HUST). Wuhan, Hubei, PR China

DOI: 10.32474/RRHOAJ.2021.06.000237

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Background: Electrophysiological studies always remained essential to differentiate the type of pre-excitation syndrome in arrhythmia. We explore mahaim fibers’ role instead of a bundle of his in the accessory pathway to diagnose left bundle branch block. Case presentation: A asymptomatic 51-year-old man was present in the outpatient department with a history of myocardial infarction over several years. The classical pre-excitation syndrome remains classical without delta waves. Trans-esophageal atrial pacing was induced using electrocardiogram and intracardiac electrogram (IEGM) to study further morphological changes of QRS in all directions.

Diagnosis: The evaluated accessory pathway before and after ablation at anterolateral bypass potentially synchronous the transitional R wave at the electrical axis, recording the positive and negative sign readings. The morphology pattern closer to the left bypass’s origin at the frontalis concludes the left bundle branch block, which was misdiagnosed earlier with the right bundle branch block.

Conclusion: This is the first case report which elaborated the importance of retrograde study in uni-directional stimulus that significantly identified the maximum QRS terminal vector changes in rhythm disorder.

KeywordsPre-Excitation; QRS Terminal Vector; Mahaim Fiber; Left Bundle Branch Block; Ablation.

Abbreviations:ECG: Electrocardiogram; SVT: Supraventricular tachycardia; AP: Accessory pathway; PS2 : Phase segment; AH interval: Atrial his interval; AV node: Atrioventricular node; NV node: Nodo-ventricular node; STEMI: ST-elevation myocardial infarction; NSTEMI: Non-ST elevation myocardial infarction; RBBB: Right bundle branch block; LBBB: Left bundle branch block

Abstract| Introduction| Case Presentations| Discussion| Limitation of Study| >Conclusion| Patient Perspectivet| Reference|