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Journal articles on the topic 'Incomplete right bundle branch block'

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Published: 5 June 2025

Last updated: 16 July 2025

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Spodick, David H. "Exercise and incomplete right bundle branch block." Journal of the American College of Cardiology 9, no. 2 (1987): 469. http://dx.doi.org/10.1016/s0735-1097(87)80414-x.

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Albæk, Diana H. R., Sebastian Udholm, Anne-Sif L. Ovesen, Zarmiga Karunanithi, Camilla Nyboe, and Vibeke E. Hjortdal. "Pacemaker and conduction disturbances in patients with atrial septal defect." Cardiology in the Young 30, no. 7 (2020): 980–85. http://dx.doi.org/10.1017/s1047951120001365.

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AbstractObjective:To determine the prevalence of pacemaker and conduction disturbances in patients with atrial septal defects.Design:All patients with an atrial septal defect born before 1994 were identified in the Danish National Patient Registry, and 297 patients were analysed for atrioventricular block, bradycardia, right bundle branch block, left anterior fascicular block, left posterior fascicular block, pacemaker, and mortality. Our results were compared with pre-existing data from a healthy background population. Further, outcomes were compared between patients with open atrial septal defects and atrial septal defects closed by surgery or transcatheter.Results:Most frequent findings were incomplete right bundle branch block (40.1%), left anterior fascicular block (3.7%), atrioventricular block (3.7%), and pacemaker (3.7%). Average age at pacemaker implantation was 32 years. Patients with defects closed surgically or by transcatheter had an increased prevalence of atrioventricular block (p < 0.01), incomplete right bundle branch block (p < 0.01), and left anterior fascicular block (p = 0.02) when compared to patients with unclosed atrial septal defects. At age above 25 years, there was a considerably higher prevalence of atrioventricular block (9.4% versus 0.1%) and complete right bundle branch block (1.9% versus 0.4%) when compared to the background cohorts.Conclusions:Patients with atrial septal defects have a considerably higher prevalence of conduction abnormalities when compared to the background population. Patients with surgically or transcatheter closed atrial septal defects demonstrated a higher demand for pacemaker and a higher prevalence of atrioventricular block, incomplete right bundle branch block, and left anterior fascicular block when compared to patients with unclosed atrial septal defects.

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Floria, Mariana, Alexandra Noela Parteni, Ioana Alexandra Neagu, Radu Andy Sascau, Cristian Statescu, and Daniela Maria Tanase. "Incomplete right bundle branch block: Challenges in electrocardiogram diagnosis." Anatolian Journal of Cardiology 25, no. 6 (2021): 380–84. http://dx.doi.org/10.5152/anatoljcardiol.2021.84375.

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MAURIC, A. T. F., N. J. SAMANI, and D. P. DE BONO. "When should we diagnose incomplete right bundle branch block?" European Heart Journal 14, no. 5 (1993): 602–6. http://dx.doi.org/10.1093/eurheartj/14.5.602.

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Hancock, E. William. "What Is the Cause of Incomplete Right Bundle Branch Block?" Hospital Practice 22, no. 4 (1987): 81–85. http://dx.doi.org/10.1080/21548331.1987.11707694.

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CALABRÒ, MARIA PIA, ORESTE BRAMANTI, and GIUSEPPE ORETO. "Incomplete Right Bundle Branch Block During Supraventricular Tachycardia: Fact or Fiction?" Journal of Cardiovascular Electrophysiology 14, no. 1 (2003): 107–8. http://dx.doi.org/10.1046/j.1540-8167.2003.02308.x.

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Zahn, Greg, Julie L. Welch, and Steve Roumpf. "Distinguishing between Brugada and incomplete right bundle branch block on ECG." Visual Journal of Emergency Medicine 16 (July 2019): 100608. http://dx.doi.org/10.1016/j.visj.2019.100608.

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Noben, Lore, Sally-Ann Clur, Judith OEH van Laar, and Rik Vullings. "Prenatal diagnosis of a bundle branch block based on the fetal ECG." BMJ Case Reports 12, no. 7 (2019): e229998. http://dx.doi.org/10.1136/bcr-2019-229998.

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A non-invasive fetal ECG was performed on a 36-year-old pregnant woman at 24+6 weeks of gestation as part of ongoing clinical research. A paediatric cardiologist suspected an incomplete bundle branch block based on the averaged ECGs from the recording. The characteristic terminal R’ wave was present in multiple leads of the fetal ECGs. A fetal anomaly scan had been performed at 20 weeks of gestation and showed no abnormalities. An incomplete right bundle branch block was confirmed on an ECG recorded at the age of 2 years. This case shows the possibility of novel non-invasive fetal ECG technology as an adjunct to the diagnosis of fetal cardiac anomalies in the future.

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Chepurnenko, S. A., G. V. Shavkuta, and M. S. Chepurnenko. "Manifestation of stenosis of the anterior interventricular branch of the left coronary artery: the Hiss beam legs blockade." Russian Journal of Preventive Medicine 28, no. 5 (2025): 96. https://doi.org/10.17116/profmed20252805196.

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The most common conduction disorder is right bundle branch block (RBBB). The prevalence of complete right bundle branch block (CRBBB) is 0.5—1.4%, and for incomplete RBBB, it is 0.6—4.7%. In some conditions, the CRBBB indicates a worsening of the prognosis. Objective. To compare the changes on the electrocardiogram as a sequential occurrence of a left anterior hemiblock and then a complete right bundle branch block with the results of coronary angiography to use this clinical case for prognostic purposes in other patients. Results. We present a clinical case of significant coronary stenosis with a bifascicular heart block in a 53-year-old patient without anginal pain with factors that increase the pre-test probability of coronary heart disease: hypertension, diabetes mellitus, gouty arthritis, 20 years history of smoking, and a sedentary lifestyle. The left anterior hemiblock was first identified on 09/09/20, CRBBB was diagnosed on the electrocardiogram on 06/15/24, and the intraventricular conduction disorder as a widening of the QRS complex increased over time (from 0.16 to 0.20 mm). It is known from the anatomy and physiology of the cardiac conduction system that both branches are supplied with blood from the left anterior descending artery (LADA). Coronary angiography showed 80% stenosis at the mouth of LADA. Stenoses of other arteries were not identified. The patient underwent LADA stenting. Conclusion. Cardiologists, internists, and general practitioners should pay special attention to all cases of a combination of complete right bundle branch block and anterior left bundle branch block, assess them for possible significant stenosis of the left anterior descending artery, and refer the patient to invasive coronary angiography. This approach helps to alter the course of the disease and improve the prognosis.

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Angoorani, Hooman, and Mohamadsadegh Haghi. "Electrocardiography Findings in Iranian Premier League Football Players." Galen Medical Journal 4, no. 4 (2015): 151–58. http://dx.doi.org/10.31661/gmj.v4i4.381.

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Background: Sudden cardiac death (SCD) is the leading cause of death in athletes during sport. Electrocardiography (ECG) is a useful tool to detect underlying cardiovascular conditions that may increase the risk for SCD. The aim of the present study is to evaluate common ECG changes among professional football players. Materials and Methods: All football players of Iranian Premier League in season 2013-2014 participated in this descriptive study (258 football players). The standard 12-lead ECGs were evaluated and ECG analysis was performed according to previously described criteria. Results: Electrocardiogram evaluation showed that the percent of ECG changes was as follows; Inverted T (7.7%), Depression ST (2.3%), Bradycardia (0.3%), St Elevation (2.7%), Left ventricular hypertrophy (1.5%), Left bundle branch block (0.3%), Incomplete right bundle branch (0.3%), Incomplete left anterior bundle (0.8%), branch Incomplete left posterior bundle branch (1.1%), Wolf Parkinson white (0.3%), Left axis deviation (1.5), Right axis deviation (2.3%), ECG finding in favor of HCM (3.1%) and finally ECG finding in favor of IHD(10%). Conclusion: Most electrocardiographic variables in Iranian professional football players were lower than the worldwide football players that may be related to the lower level of physical fitness among Iranian football players.[GMJ.2015;4(4):151-58]

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Butchenko, L. A., and V. L. Butchenko. "Incomplete block of the right branch of the his' bundle in sportsmen." Sports Medicine, Training and Rehabilitation 1, no. 1 (1988): 45–47. http://dx.doi.org/10.1080/15438628809511843.

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Liao, Youlian, Linda Ann Emidy, Alan Dyer, et al. "Characteristics and prognosis of incomplete right bundle branch block: An epidemiologic study." Journal of the American College of Cardiology 7, no. 3 (1986): 492–99. http://dx.doi.org/10.1016/s0735-1097(86)80458-2.

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Diaz‐Gonzalez, Leonel, Vanesa Bruña, Jesús Velásquez‐Rodriguez, et al. "Young athletes' ECG: Incomplete right bundle branch block vs crista supraventricularis pattern." Scandinavian Journal of Medicine & Science in Sports 30, no. 10 (2020): 1992–98. http://dx.doi.org/10.1111/sms.13763.

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Manolis, Antonis S., John A. Chiladakis, John S. Malakos, Vassilis Vassilikos, Themos Maounis, and Dennis V. Cokkinos. "Abnormal signal-averaged electrocardiograms in patients with incomplete right bundle-branch block." Clinical Cardiology 20, no. 1 (1997): 17–22. http://dx.doi.org/10.1002/clc.4960200106.

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Cirillo, Chiara, Emanuele Monda, Raffaella Esposito, et al. "Prevalence and Clinical Significance of Intraventricular Conduction Disturbances in Hospitalized Children." Journal of Cardiovascular Development and Disease 11, no. 4 (2024): 129. http://dx.doi.org/10.3390/jcdd11040129.

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Introduction: Data on the prevalence and clinical significance of interventricular conduction disturbances (IVCDs) in children are scarce. While incomplete right bundle branch blocks (IRBBBs) seem to be the most frequent and benign findings, complete bundle blocks and fascicular blocks are often seen in children with congenital/acquired cardiac conditions. This study aims to delineate the prevalence and the diagnostic accuracy of IVCD in children admitted to a paediatric cardiology unit. Methods: Children admitted to the paediatric cardiology unit between January 2010 and December 2020 who had an ECG were included in the study. IVCDs were diagnosed according to standard criteria adjusted for age. Results: Three thousand nine hundred and ninety-three patients were enrolled. The median age was 3.1 years (IQR: 0.0–9.2 years), and 52.7% were males. IVCDs were present in 22.5% of the population: 17.4% of the population presented with IRBBBs, 4.8% with a complete right bundle branch block (CRBBB), 0.1% with a complete left bundle branch block (CLBBB), 0.2% with a left anterior fascicular block (LAFB) and 0.2% with a combination of CRBBB and LAFB. Also, 26% of children with congenital heart disease had an IVCD, and 18% of children with an IVCD had previous cardiac surgery. The overall sensitivity of IVCD in detecting a cardiac abnormality was 22.2%, with a specificity of 75.5%, a PPV of 83.1% and an NPV of 15.1%, but the values were higher for CLBBB and LAFB. Conclusions: IVCDs were present in one-fifth of children admitted to the cardiology unit. IRBBB was the most frequent disturbance, while CRBBB, CLBBB and fascicular blocks were much rarer, though they had a higher predictive value for cardiac abnormalities.

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Nielsen, J. B., M. S. Olesen, M. Tango, S. Haunso, A. G. Holst, and J. H. Svendsen. "Incomplete right bundle branch block: a novel electrocardiographic marker for lone atrial fibrillation." Europace 13, no. 2 (2010): 182–87. http://dx.doi.org/10.1093/europace/euq436.

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Lazovic, Biljana, Nevena Jovicic, Vladimir Radlovic, et al. "Electrocardiographic predictors of five years mortality in chronic obstructive pulmonary disease patients." Srpski arhiv za celokupno lekarstvo, no. 00 (2020): 104. http://dx.doi.org/10.2298/sarh200506104l.

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Introduction/Objective. Cardiovascular disease is one of the most common comorbidities among subjects with chronic obstructive pulmonary disease (COPD). The aim of this study is to evaluate ECG parameters and mortality predictors in COPD patients. Methods. A total of 835 consecutive patients were included. Patients were classified to suffer from COPD if in three consecutive postbronhodilatator measurements FEV1/FVC was <70%. Following ECG changes were observed: axis, p wave, low ORS complex, transitional zone, left bundle branch block (LBBB), right bundle branch block (RBBB), incomplete right bundle branch block, S1S2S3 configuration, negative T in V1-V3. Patients were followed up for mortality in a five years period. Results. Both survivors and non-survivors were similar age, gender and COPD status. FVC and FEV1 as well as GOLD stadium are significantly higher in surviving group (p<0.016, p<0.001, p<0.001 respectively). Normal axis was in significantly higher percentage in non-survived patients (p=0.020). Right RBBB and incomplete RBB are more frequent finding in patients who died as (p?0.001, p?0.05, respectively). LBBB, S1S2S3 configuration is in significantly higher percent in non survivors (p<0.016, p<0.001, respectively). In multivariable logistic model, patients with LBBB have two times higher chance of mortality compared to patients without LBBB. Contrary, patients with RBBB have 1.6 times lower chance to have death outcome. Conclusion. Main ECG predictors of COPD patients? five-year mortality are LBBB and RBBB, but according to statistical model, electrocardiogram should be further explored and possibly obligatory involved in a routine clinical practice as an easy and low-cost screening method.

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Gomes, Otoni M., Ant�nio Alves Coelho, Evandro C�sar Vidal Osterne, and Rafael Diniz Abrantes. "Coronary Morphology and Conduction System Disturbance Induced by Therapeutic Embolization of the Coronary Septal Artery." Heart Surgery Forum 13, no. 1 (2010): 45. http://dx.doi.org/10.1532/hsf98.20091133.

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Background: Percutaneous transluminal septal myocardial alcohol ablation (PTSMAA) is not a procedure without complications. It may produce heart arrhythmias, especially those due to disturbances of atrioventricular (AV) and interventricular (IV) electrical conduction.Objective: The goal of this study was to evaluate the relationship between the anatomical patterns of the right coronary artery and the left anterior descending artery (LAD) and to relate them to the AV and IV bundle branch blocks provoked by PTSMAA.Method: Twenty patients with obstructive hypertrophic cardiomyopathy resistant to treatment with drugs successfully underwent PTSMAA. Electrocardiographic analyses were done before and after PTSMAA, and the results were compared with the abnormal septal anatomy.Results: The effectiveness of PTSMAA was obtained in 18 (90%) of the 20 patients by ethanolization of the first great septal branch. In the other 2 patients (10%), 2 septal branches underwent alcoholization. First-grade temporary AV block (AVB) was observed in 6 patients (30%). Ten patients experienced severe bradycardia due to total AVB that required a temporary pacemaker, but 3 of the patients (15%) required a permanent pacemaker. Fourteen patients (70%) experienced permanent complete right branch block, and 2 developed incomplete left anterior block and incomplete left posterior block. Six patients presented with no electrical conduction disturbance at all.Conclusion: According to the results of the present investigation with the AV node artery derived from the right coronary artery in all cases, complete and permanent AV conduction system blockade occurred after PTSMAA in all types of anatomy regarding the observed LAD.

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Mu, Yan-Guang, and Ke-Sen Liu. "Selective his bundle pacing eliminates crochetage sign: A case report." World Journal of Clinical Cases 12, no. 22 (2024): 5276–81. http://dx.doi.org/10.12998/wjcc.v12.i22.5276.

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BACKGROUND Crochetage sign is a specific electrocardiographic manifestation of ostium secundum atrial septal defects (ASDs), which is associated with the severity of the left-to-right shunt. Herein, we reported a case of selective his bundle pacing (S-HBP) that eliminated crochetage sign in a patient with ostium secundum ASD. CASE SUMMARY A 77-year-old man was admitted with a 2-year history of chest tightness and shortness of breath. Transthoracic echocardiography revealed an ostium secundum ASD. Twelve-lead electrocardiogram revealed atrial fibrillation with a prolonged relative risk interval, incomplete right bundle branch block, and crochetage sign. The patient was diagnosed with an ostium secundum ASD, atrial fibrillation with a second-degree atrioventricular block, and heart failure. The patient was treated with selective his bundle pacemaker implantation. After the procedure, crochetage sign disappeared during his bundle pacing on the electrocardiogram. CONCLUSION S-HBP eliminated crochetage sign on electrocardiogram. Crochetage sign may be a manifestation of a conduction system disorder.

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Ryabykina, G. V. "ECG changes in COVID-19." Kardiologiia 60, no. 8 (2020): 16–22. http://dx.doi.org/10.18087/cardio.2020.8.n1192.

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Aim To evaluate changes in 12-lead ECG in patients with coronavirus infection.Materials and methods This article describes signs of electrocardiographic right ventricular “stress” in patients with COVID-19. 150 ECGs of 75 COVID-19 patients were analyzed in the Institute of Cardiology of the National Medical Research Centre for Therapy and Preventive Medicine. The diagnosis was based on the clinical picture of community-acquired pneumonia, data of chest multispiral computed tomography, and a positive test for COVID-19. ECG was recorded both in 3-6 and in 12 leads. Signs of right ventricular (RV) stress, so-called systolic overload (high R and inverted TV1–3 and TII, III, aVF), and diastolic overload (RV wall hypertrophy and cavity dilatation; complete or incomplete right bundle branch block) were evaluated.Results The most common signs for impaired functioning of the right heart include emergence of the RV P wave phase (41.3 %), incomplete right bundle branch block (42.6 %), ECG of the SIQ IIITIII type (33.3 %) typical for thromboembolic complications, and signs of RV hypertrophy, primarily increased SV5–6 (14.7 %). These changes are either associated with signs of RV myocardial stress (16 %) or appear on the background of signs for diffuse hypoxia evident as tall, positive, sharp-ended T waves in most leads (28 %).Conclusion A conclusive, comprehensive assessment of the reversal of hemodynamic disorders and electrocardiographic dynamics in patients with COVID-19 will be possible later, when more data become available.

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Lorber, Avraham, Ernesto Maisuls, and Johanan Naschitz. "Hereditary right axis deviation: electrocardiographic pattern of pseudo left posterior hemiblock and incomplete right bundle branch block." International Journal of Cardiology 20, no. 3 (1988): 399–402. http://dx.doi.org/10.1016/0167-5273(88)90295-1.

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Ben Abdesslem, M., O. Ben Rejeb, I. Bouhlel, A. Mahdhaoui, S. Ernez, and G. Jeridi. "Prevalence of complete and incomplete right bundle branch block in young athletes: A local study." Archives of Cardiovascular Diseases Supplements 11, no. 1 (2019): 116. http://dx.doi.org/10.1016/j.acvdsp.2018.10.255.

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Murtuza, Shahid, Shyam Raj Regmi, Bishnu Mani Dhital, et al. "MORPHOLOGIC CHARACTERISTICS AND FUNCTION OF RIGHT VENTRICLE IN PATIENTS WITH ISOLATED RIGHT BUNDLE BRANCH BLOCK." Journal of Chitwan Medical College 12, no. 3 (2022): 106–10. http://dx.doi.org/10.54530/jcmc.1153.

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Background: The prevalence of right bundle branch block (RBBB) is estimated in 0.2 to 1.3% of healthy people. RBBB had independent association with decreased right ventricle (RV) function, which is considered as predictor of adverse cardiovascular outcomes. The aim of this study is to evaluate RV structure and function in patients with isolated RBBB (without structural heart disease) using two-dimensional echocardiography. Methods: A cross-sectional study conducted at Chitwan Medical College, Bharatpur from 1st January 2022 to 30th June 2022. Consecutive adult patients aged ≥18 years with isolated RBBB classified into complete RBBB (CRBBB) and Incomplete RBBB (IRBBB) based on electrocardiographic findings. The echocardiographic evaluation was done to assess RV dimension and function. Results: A total of 52 patients with isolated RBBB were included with mean age of the study population was 45.3 ± 9.3 years, (28 ,53.8%) had CRBBB, whereas the remaining (24, 46.2%) had IRBBB. Among the parameters used to assess RV function; mean RV-Fractional area change (P<0.001), Tricuspid annular plane systolic excursion(P<0.02) and Pulsed Doppler peak velocity at the lateral annulus RV(P<0.001) were significantly lower, while Pulsed Doppler myocardial performance index(P<0.001) was significantly high in CRBBB group as compared to IRBBB group. Similarly, Right atrium and RV dimensional parameters were significant higher in CRBBB compared to IRBBB group. Conclusions: Isolated RBBB is not as benign as it was considered and has deteriorating effect on RV morphology and function. Therefore, patients with Isolated RBBB need follow-up with passing age and more attention toward RV structural and functional analysis.

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P., Renuga, Thirunavukarasu P., and Balamanikandan P. "Study of Conduction Abnormalities in Acute Myocardial Infarction." International Journal of Pharmaceutical and Clinical Research 15, no. 2 (2023): 98–103. https://doi.org/10.5281/zenodo.12798292.

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Myocardial infarction is the most common non-communicable disease responsible for increasing mortality worldwide, especially in India. The aim of the study is to record electrocardiograph in acute myocardial infarction patients and interpret conduction abnormalities associated with it to prevent mortality and morbidity.This study was conducted in District Headquarters Hospital & DNB Postgraduate Teaching Institute, Virudhunagar. It is a cross sectional study conducted for a period of 14 months between March 2020- April 2021 with a sample size of hundred patients<em>.</em>In our study incidence of conduction abnormalities in acute MI is 63%. Incomplete right bundle branch block is the most common conduction defect followed by left anterior hemi block. Anterior wall MI is the most prevalent followed by inferior wall MI. Increased Risk of mortality in patients presenting with High degree heart blocks.Hence as per our study it’s always better to evaluate conduction abnormalities in MI patients so have proper observation and follow up to reduce morbidity and mortality.

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Senftinger, Juliana, Yama Fakhri, Jonas Isaksen, et al. "Poster Session 2The morphology of complete and incomplete right bundle branch block in the general population." Journal of Electrocardiology 73 (July 2022): 14–15. http://dx.doi.org/10.1016/j.jelectrocard.2022.07.040.

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Yarysheva, V. B., and D. Z. Shibkova. "Genetic predictors of cardiovascular system adaptation in adolescents to physical stress." Kazan medical journal 98, no. 1 (2017): 63–66. http://dx.doi.org/10.17750/kmj2017-63.

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Aim. Analysis of genetic markers of physical performance and their interrelation with electrocardiographic parameters in athletes of the youth league.Methods. The study involved 204 of adolescent athletes. EKGs were performed, the profile of genes of folate cycle and genes encoding the function of angiotensin-converting enzyme was detected by polymerase chain reaction in venous blood.Results. It was found that all participants had sinus rhythm. Arrhythmias and conduction disorders were revealed: bradycardia was observed in 22 (10.7%) of participants, normocardia - in 168 (82%) participants, tachycardia - in 14 (6.8%) participants, incomplete right and left bundle branch block - in 16 (7.7%) participants, and repolarization disorders of left ventricle - in 5 (2.4%) young athletes. The genes polymorphism of folate cycle and genes encoding the function of angiotensin-converting enzyme in the examined individuals were presented in different variants. Majority of the participants had heterozygous forms in most genes except for the gene NOS3 894 G>T presented as a dominant form.Conclusion. Accordng to EKG the athletes of the youth league had early repolarization of the left ventricle (2.4% cases), incomplete right or left bundle branch block (7.7% cases), and normal waves and intervals; according to genetic study most participants had heterozygous genotype GNB3 825 C>T, NOS3-786 T>C, AGT 704 T>C, negative correlation of QTc with NOS3-786 T>C and NOS3 894 G>T, α-angle / AGT 704 T>C with P-wave / NOS3 894 G>T.

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Ruiz-Guevara, Raiza, Belkisyolé Alarcón de Noya, Iván Mendoza, et al. "Ten years follow-up of the largest oral Chagas disease outbreak: Cardiological prospective cohort study." PLOS Neglected Tropical Diseases 17, no. 10 (2023): e0011643. http://dx.doi.org/10.1371/journal.pntd.0011643.

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Background Chagas disease (ChD) is the most important endemy in Latin America. Some patients, develop chronic Chagasic cardiopathy (CCC) years after the acute phase. It is unknown if patients infected by the oral route have higher risk of developing early CCC. Methods and findings A prospective cohort study was conducted to assess morbidity and mortality during 10 years observation in 106 people simultaneously infected and treated in the largest known orally transmitted ChD outbreak in 2007. A preschooler died during the acute phase, but thereafter was no mortality associated to ChD. All acute phase findings improved in the first-year post-treatment. Each person was evaluated 8.7 times clinically, 6.4 by electrocardiogram (ECG)/Holter, and 1.7 by echocardiogram. Based on prevalence, the number of people who had any abnormalities (excluding repolarization abnormalities and atrial tachycardia which decreased) was higher than 2007, since they were found at least once between 2008–2017. However, when we evaluated incidence, except for clinical bradycardia and dizziness, it was observed that the number of new cases of all clinical and ECG findings decreased at the end of the follow-up. Between 2008–2017 there was not incidence of low voltage complex, 2nd degree AV block, long QT interval, left bundle branch block or left ventricular dysfunction that allowed the diagnosis of CCC. Total improvement prevailed over the persistence of all clinical and ECG/Holter findings, except for sinus bradycardia. Incomplete right bundle branch block, sinus bradycardia and/or T-wave inversion were diagnosed persistently in 9 children. The second treatment did not have significant influence on the incidence of clinical or ECG/Holter findings. Conclusions At the end of the 10-year follow-up, there were not clinical or ECG/Holter criteria for classifying patients with CCC. The incidence of arrhythmias and repolarization abnormalities decreased. However, special attention should be paid on findings that not revert as sinus bradycardia, or those diagnosed persistently in all ECG as sinus bradycardia, incomplete right bundle branch block or T-wave inversion. Early diagnosis and treatment may have contributed to the rapid improvement of these patients. In ChD follow-up studies prevalence overestimates the real dimension of abnormalities, the incidence looks as a better indicator.

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Nasir, Javed M., Anand Shah, and Samuel Jones. "THE SIGNIFICANCE OF INCOMPLETE AND COMPLETE RIGHT BUNDLE BRANCH BLOCKS IN YOUNG ADULTS." Journal of the American College of Cardiology 59, no. 13 (2012): E1939. http://dx.doi.org/10.1016/s0735-1097(12)61940-8.

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SUMIYOSHI, Masataka, Yasuro NAKATA, Teruhiko HISAOKA, et al. "A Case of Idiopathic Ventricular Fibrillation with Incomplete Right Bundle Branch Block and Persistent ST Segment Elevation." Japanese Heart Journal 34, no. 5 (1993): 661–66. http://dx.doi.org/10.1536/ihj.34.661.

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Ohkubo, Kimie, Ichiro Watanabe, Yasuo Okumura, et al. "A New Criteria Differentiating Type 2 and 3 Brugada Patterns From Ordinary Incomplete Right Bundle Branch Block." International Heart Journal 52, no. 3 (2011): 159–63. http://dx.doi.org/10.1536/ihj.52.159.

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Teregulov, Yu E., M. M. Mangusheva, I. I. Miliutina, F. R. Chuvashaeva, and F. N. Muhametshina. "Criteria for right bundle branch block based on three-dimensional vectorcardiography. Possibilities of differential diagnostics." Medical alphabet, no. 4 (April 21, 2025): 17–24. https://doi.org/10.33667/2078-5631-2025-4-17-24.

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Relevance. Right bundle branch block (RBBB) has characteristic manifestations on an ECG, however, in clinical practice, when combined with another pathology – myocardial infarction, arrhythmogenic right ventricular dysplasia, combined damage to the conduction system, etc. difficulties may arise in interpretation.The purpose of the study. Development of RBBB criteria based on three-dimensional vector analysis with an assessment of the rate of formation of a spatial vector loop.Material and methods. The main group included 64 patients with BPH, including 42 men and 22 women, with an average age of 31.1±9.62 (M±σ) years. Patients with complete and incomplete RBBB were identified according to the accepted ECG criteria. The control group included 80 healthy patients with an average age of 31.5±6.3 (M±σ) years, 54 of them women and 26 men. Synchronous recording of 12 standard leads was performed in all patients, followed by reconstruction of a three-dimensional ECG using the EasyECG Rest ATES Medica software (Russia).The results of the study and conclusions. The criteria of RBBB based on three-dimensional ECG with an analysis of the spatial vector loop tracing rate have been determined, which remain effective in combination with left anterior fascicular block, and also allow for differential diagnosis with myocardial infarction, with epsilon wave in arrhythmogenic right ventricular dysplasia and other diseases of the cardiovascular system.

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Georgijevic, Ljubica, and Lana Andric. "Electrocardiography in pre-participation screening and current guidelines for participation in competitive sports." Srpski arhiv za celokupno lekarstvo 144, no. 1-2 (2016): 104–10. http://dx.doi.org/10.2298/sarh1602104g.

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Electrocardiography (ECG) is especially significant in pre-participation screening due to its ability to discover or to rise a suspicion for certain cardiovascular diseases and conditions that represent a serious health risk in athletes. Common, conditionally benign and training related ECG changes are sinus bradycardia and sinus arrhythmia, first degree atrioventricular block, incomplete right bundle branch block, benign early repolarization, and isolated QRS voltage criteria for left ventricular enlargement. Uncommon ECG changes, unrelated to training, and some specific syndromes are ST segment depression and/or ? 2mm T wave inversion in two or more adjacent leads, intraventricular conduction disorder, Wolf-Parkinson-White syndrome, long QT interval syndrome, short QT interval syndrome, catecholaminergic polymorphic ventricular tachycardia, monomorphic ventricular extrasystole and benign ventricular tachycardia.

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Mohanan Nair, Krishna Kumar, Narayanan Namboodiri, Hiren Kevadiya, and Ajitkumar Valaparambil. "An interesting case of narrow QRS tachycardia with incomplete right bundle branch block morphology: What is the mechanism?" Journal of Cardiovascular Electrophysiology 29, no. 8 (2018): 1177–80. http://dx.doi.org/10.1111/jce.13609.

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Meziab, Omar, Dominic J. Abrams, Mark E. Alexander, et al. "Utility of incomplete right bundle branch block as an isolated ECG finding in children undergoing initial cardiac evaluation." Congenital Heart Disease 13, no. 3 (2018): 419–27. http://dx.doi.org/10.1111/chd.12589.

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Chevallier, Stéphane, Andrei Forclaz, Joanna Tenkorang, et al. "New Electrocardiographic Criteria for Discriminating Between Brugada Types 2 and 3 Patterns and Incomplete Right Bundle Branch Block." Journal of the American College of Cardiology 58, no. 22 (2011): 2290–98. http://dx.doi.org/10.1016/j.jacc.2011.08.039.

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Madias, John E. "Early repolarization associated with accelerated atrioventricular conduction (short PR interval) and incomplete right bundle branch block: postulated mechanisms." Journal of Electrocardiology 41, no. 1 (2008): 35.e1–35.e7. http://dx.doi.org/10.1016/j.jelectrocard.2007.05.017.

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Niwa, Koichiro, Naomi Warita, Yuko Sunami, Akimitsu Shimura, Shigeru Tateno, and Katsuo Sugita. "Prevalence of arrhythmias and conduction disturbances in large population-based samples of children." Cardiology in the Young 14, no. 1 (2004): 68–74. http://dx.doi.org/10.1017/s104795110400112x.

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The aim of our study is to provide data on the prevalence of disturbances of rhythm in the general population of children. Accurate estimates of true prevalence of such disturbances of rhythm from large samples are mandatory if we are to interpret properly electrocardiographic abnormalities. We analysed prevalence of disturbances of rhythm in a population of 152,322, comprised of 71,855 elementary school students, 36,692 males and 35,163 females, aged from 5 to 6 years, and 80,467 students of junior high school, 41,842 males and 38,625 females, aged from 12 to 13 years. We analysed the prevalence of premature atrial and ventricular contractions, first, second and third degree atrioventricular block, incomplete and complete right bundle branch block, Wolff-Parkinson-White syndrome, and prolongation of the QT interval. The prevalence of disturbances of rhythm in total rose with age, being found in 1.25% of elementary school students and 2.32% of junior high school students, and was higher in males than females, at 2.00% as opposed to 1.38%, both values being statistically significant at a level of less than 0.0001. Prevalences of all types of rhythmic disturbances were higher in junior high school students than elementary school students (p < 0.0001). Premature atrial and ventricular contractions and prolongation of the QT interval were higher in female than male students, at percentages of 0.089, 0.497, and 0.02 for males, and 0.123, 0.534 and 0.027 in females (p < 0.0001). In contrast, incomplete and complete right bundle branch blocks were higher in males than females, at 0.983% and 0.083% in males versus 0.410% and 0.161% in females (p < 0.0001). Disturbances of rhythm increased with age, and conduction disturbances were higher in male students than female, although premature atrial and ventricular contractions and prolongation of the QT interval were more frequent in female. These data may be useful for future comparative studies of disturbance of rhythm in children.

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Liu, Peipei, Yanxiu Wang, Xiaofu Zhang, et al. "Obesity and Cardiac Conduction Block Disease in China." JAMA Network Open 6, no. 11 (2023): e2342831. http://dx.doi.org/10.1001/jamanetworkopen.2023.42831.

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ImportanceAlthough a high body mass index (BMI) has been found to be associated with increased risk of cardiac conduction block (CCB) in older adults, no further studies have investigated the association between obesity and CCB in the general population.ObjectiveTo investigate the association between obesity and CCB, including its subtypes.Design, Setting, and ParticipantsThis cohort study used data from participants in the Kailuan Study in China (2006-2018) who had completed a physical examination in 2006 (baseline) and had not experienced CCB before baseline. Data analysis was conducted from March to September 2023.ExposuresObesity status was defined by BMI in 3 groups: normal weight (18.5 to &amp;lt;24), overweight (24 to &amp;lt;28), and obesity (≥28).Main Outcome and MeasuresThe primary outcome was CCB, which was diagnosed from standard 12-lead electrocardiography. The primary end point included high-grade atrioventricular block (HAVB), complete right bundle branch block, complete left bundle branch block, left anterior fascicular block (LAFB), and left posterior fascicular block. First-degree atrioventricular block (FAVB), second-degree type 1 AVB, HAVB, complete and incomplete right and left bundle branch block, LAFB, and left posterior fascicular block were considered separately as secondary end points.ResultsAmong 86 635 participants (mean [SD] age, 50.8 [11.9] years; 68 205 males [78.7%]), there were 33 259 individuals with normal weight (38.4%), 37 069 individuals with overweight (42.8%), and 16 307 individuals with obesity (18.8%). The mean (SD) follow-up was 10.6 (3.07) years. In the multivariable Cox proportional hazards regression analysis, obesity was associated with an increased risk of incident CCB (hazard ratio [HR], 1.21; 95% CI, 1.04-1.42) vs normal BMI. In secondary analysis, obesity was associated with an increased risk of FAVB (HR, 1.44; 95% CI, 1.21-1.73), HAVB (HR, 1.99; 95% CI, 1.03-3.82), and LAFB (HR, 1.29; 95% CI, 1.03-1.62) vs normal BMI. There was no association between obesity and other CCB subtypes. Obesity was associated with a greater increase in risk of CCB vs normal BMI in older (aged ≥65 years; HR, 1.44; 95% CI, 1.05-1.96) vs younger (aged &amp;lt;65 years; HR, 1.13; 95% CI, 0.96-1.34) participants (P for interaction &amp;lt; .001) and those with diabetes (HR, 2.16; 95% CI, 1.24-3.76) vs without diabetes (HR, 1.19; 95% CI, 1.02-1.39) (P for interaction = .02).Conclusions and RelevanceThis study found that obesity was associated with an increased risk of CCB, with greater increases in risk for FAVB, HAVB, and LAFB. Individuals who were older and those who had diabetes had larger increases in risk.

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Mazic, Sanja, Biljana Lazovic, Marina Djelic, Zoran Stajic, and Zdravko Mijailovic. "Electrocardiographic specificities in athletes." Medical review 66, no. 5-6 (2013): 225–32. http://dx.doi.org/10.2298/mpns1306225m.

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Introduction. The use of electrocardiogram in athletes as a routine screening method for diagnosing potentially dangerous cardiovascular diseases is still an issue of debate. According to the guidelines of the European Society of Cardiology, the recording of electrocardiogram is necessary in all athletes as a screening method, whereas the guidelines of the American Heart Association do not necessitate an electrocardiogram as a screening method and they insist on detailed personal and family history and clinical examination. Classification of electrocardiogram changes in athletes. According to the classification of the European Society of Cardiology, electrocardiogram changes in athletes are divided into two groups: a) usual (physiological) that are connected with training; b) unusual (potentially clinically relevant) that are not connected with training. Sudden cardiac death in athletes. The most frequent causes include hypertrophic cardiomyopathy and congenital coronary artery anomalies, while others may be found only sporadically at autopsy. Physiological electrocardiogram changes are frequent in asymptomatic athletes and they do not require further assessment. They include sinus bradycardia, atrioventricular blocks of I and II degree - Wenkebach, isolated increased QRS voltage, incomplete right bundle branch block and early repolarization. Potentially pathological electrocardiogram changes in athletes are not frequent but they are alarming and they urge further assessment to diagnose the underlying cardiovascular disease as well as the prevention of sudden cardiac death. They include: T wave inversion, ST segment depression, complete right or left bundle branch block, atrial pre-excitation syndrome-WPW, long QT interval, short QT interval, Brugada like electrocardiogram finding. Conclusion. Introduction of electrocardiogram recording into the screening protocol in athletes increases the sensitivity of evaluation and may help to discover asymptomatic cardiovascular diseases that may cause sudden cardiac death. Special attention and further assessment are required when the above potentially pathological electrocardiogram changes are found in athletes.

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Kaisbain, Neerusha, Wei Juan Lim, and Heng Shee Kim. "Atrial septal defect with Crochetage sign presenting with pulmonary artery thrombosis." BMJ Case Reports 14, no. 7 (2021): e244180. http://dx.doi.org/10.1136/bcr-2021-244180.

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Atrial septal defect (ASD) is the most common congenital heart disease observed in adult. Several ECG findings are considered sensitive for the diagnosis of ASD. We describe a 50 years old man who displayed Crochetage sign, incomplete right bundle branch block (IRBBB) and right ventricular strain pattern on ECG. Crochetage sign is highly specific for ASD and it correlates with shunt severity. The diagnostic specificity for ASD increases if the R waves have both Crochetage patterns and IRBBB. It is important not to confuse Crochetage signs with IRBBB abnormalities on ECG. Our patient was ultimately diagnosed with a large ASD measuring 3 cm with bidirectional shunt and concomitant pulmonary thrombosis. This illustrates that high suspicion of the ASD with the use of good-old ECG signs remains relevant in this modern era. This also reminds us that patients with Eisenmenger syndrome are at higher risk for pulmonary thrombosis.

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Biljana, Lazovic, Zivotic Ivan, Dmitrovic Radmila, et al. "ECG abnormalities in chronic obstructive pulmonary disease exacerbation: can the ECG record still astound us? A prospective study." Egyptian Journal of Chest Diseases and Tuberculosis 73, no. 3 (2024): 203–7. http://dx.doi.org/10.4103/ecdt.ecdt_61_23.

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Introduction/objective Chronic obstructive pulmonary disease (COPD) is a pulmonary disease characterized by persistent respiratory difficulties and impaired airflow. COPD patients have a higher risk for lung infections, like the flu or pneumonia, lung cancer, heart problems, weak muscles, brittle bones, depression, and anxiety. The purpose of this study was to estimate the prevalence of ECG abnormalities in patients with COPD experiencing exacerbations. Patients and methods The research encompassed a cohort of 832 individuals diagnosed with COPD who encountered episodes of exacerbations. Five hundred seventy-five (69.11%) of the included participants were women, and 257 (30.89%) were men. The included participants ranged from 18 to 60 years old. It was ensured that none of the participants had received any treatment for their condition for more than 3 days. Results Based on the level of exacerbation severity, the patient population is categorized into three distinct groups: moderate, comprising 330 (39.66%) individuals; severe, encompassing 406 (48.79%) individuals; and extremely severe, consisting of 96 (11.53%) individuals. During episodes of exacerbation in patients with COPD, the following ECG alterations were observed: a QTc less than 0.40 s in 99.15% of cases, a transitional ECG zone in 74.33% of cases, a P more than 2.5 mm in 45.67% of cases, an axis deviation towards the second quadrant (axis II) in 28% of cases, an incomplete right bundle branch block in 26.32% of cases, and a full right bundle branch block in 25.60% of cases. Conclusion Regardless of prior cardiac pathology, ECG is a low-cost, quick, and dependable modality for detecting ischemic changes in people experiencing a flare-up of COPD.

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Madiyono, Bambang, Ismet N. Oesman, Sudigdo Sastroasmoro, Sukman Tulus Putra, Eva Jeumpa Soelaeman, and Kukuh Basuki Rachmad. "Secundum Atrial Septal Defect Before and After Surgery." Paediatrica Indonesiana 29, no. 9-10 (2018): 199–208. http://dx.doi.org/10.14238/pi29.9-10.1989.199-208.

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Twenty patients with secundum atrial septal defect, who had undergone open heart surgery were studied retrospectively. Girls were more affected than boys; the sex ratio was 1.5 : I. Associated cardiac defects were diagnosed in two patients, one with moderate valvular pulmonic stenosis and the other one with small ventricular septal defect. Typical clinical findings consisted of loud first heart sound, widely fixed split second heart sound and soft ejection systolic murmur at the upper left sternal border were heard in all cases. Mid diastolic murmur due to relative tricuspid stenosis was detected in most cases (75%). Electrocardiographic findings included right axis deviation, prolonged PR-interval and right atrial enlargement were found in 50%, 15% and 60% of cases, respectively. Incomplete right bundle branch block and right ventricular enlargement were found in all cases, as was cardiomegaly with increased vascular markings were found in all cases. Paradoxical ventricular septal motion and visualization of the atrial septal defect were seen in 95% and 75% of cases, respectively. Cardiac catheterization was performed in 19 patients (95%). The pulmonary-systemic flow ratio (Qp/Qs) ranged from 1.7 to 6.3 (mean 2.9 ± 0.67), and was correlated to the presence of mid diastolic tricuspid flow murmur and paradoxical ventricular septal motion. Simple closure of the defect was the procedure of choice, but in one patient (5%) pericardial patch was used to close the very large defect. The mortality rate was 10 percent. Physical retardation was found in all boys and 50% of girls, before surgery. Body weight percentile increased in most cases (61.1 %), while body height percentile increased in only 5.6% of cases, postoperatively. Ejection systolic murmur at the upper left sternal border was still detected in one patient (5.6%). lncomplele right bundle branch block persisted in all cases, while cardiomegaly was still found in 5. 6% of cases followed up six months to five years after surgery. There was no residual left ventricular dysfunction in all cases.

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Hassine, Majed, Mohamed Yassine Kallala, Ahmed Jamel, et al. "The impact of right bundle branch block and SIQIII-type patterns in determining risk levels in acute pulmonary embolism." F1000Research 12 (May 24, 2023): 545. http://dx.doi.org/10.12688/f1000research.131758.1.

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Background: Electrocardiography (ECG) findings in acute pulmonary embolism (PE) are known to be related to various right ventricular (RV) alterations. These abnormalities are not included in risk stratification algorithms despite emerging evidence of their association with patient outcomes. We aimed to analyze the impact of right bundle branch block (RBBB) and/or SIQIII patterns as indicators for determining the level of risk in patients with PE. Methods: We performed a retrospective cohort study including all patients with confirmed acute PE hospitalized from January 2008 to December 2019 in two tertiary care cardiology departments. The first ECG taken at admission was selected and the analysis focused on the presence of a complete or an incomplete RBBB and SIQIII-type patterns. Results: A total of 255 patients were divided into two groups: Group I (47.8%, n=122) included patients with PE without RBBB nor SIQIII patterns, and Group II (52.2%, n=133) included patients with RBBB and/or SIQIII patterns. Patients in group II presented significantly more frequently with acute right heart symptoms (45.1% vs. 18%, p<0.001) and cardiogenic shock at admission (31.6 vs. 4.1%, p<0.001). Echocardiographic parameters indicating right heart injury also occurred more significantly in group II patients (p<0.001). By univariate analysis, patients in group II were found to be significantly associated with in-hospital mortality (22.6 vs. 6.1%, p=0.002) and major cardiovascular events (MACEs) during hospitalization (43.3 vs. 13.7%, p<0.001). Multivariate logistic regression analysis identified five independent factors predictive of MACEs: SIQIII and/or RBBB, renal failure, positive troponin levels, RV dysfunction and right heart failure symptoms during initial presentation. Kaplan-Meier survival analysis identified the inclusion in Group II and the presence of SIQIII pattern as predictors of overall mortality (p<0.001). Conclusions: Our study suggests an important and independent prognostic value of RBBB and SIQIII patterns and their usefulness in determining the outcome of PE patients.

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Probst, Vincent, Stéphanie Chatel, Jean-Baptiste Gourraud, and Hervé Le Marec. "Risk Stratification and Therapeutic Approach in Brugada Syndrome." Arrhythmia & Electrophysiology Review 1 (2012): 17. http://dx.doi.org/10.15420/aer.2012.1.17.

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Brugada syndrome (BrS) is a clinical entity characterised by an incomplete right bundle branch block associated with an ST segment elevation in the right precordial leads and a risk of ventricular arrhythmia and sudden death in the absence of structural abnormalities. Patients with a personal history of sudden death have an annual arrhythmia risk of recurrence as high as 10 %. Similarly, the presence of syncope is consistently associated with an increased arrhythmic risk. This risk can be estimated at about 1.5 % per year. The risk is lower in asymptomatic patients. Regarding the relatively high rate of complication of Implantable cardioverter defibrillator (ICD) implantation, in most of the cases, asymptomatic patients with a Brugada syndrome revealed during ajmaline challenge do not need to be implanted. The situation is more complex in patients with a spontaneous type 1 aspect since the risk could be estimated to be around 0.8 % per year. For these patients, a careful evaluation of the arrhythmic risk using all the different tools available is mandatory.

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Muresan, Ioana Danuta, Lucia Agoston-Coldea, and Dan Lucian Dumitrascu. "A 63-year-old woman with multiple secondary tumours." Heart 106, no. 3 (2020): 202–41. http://dx.doi.org/10.1136/heartjnl-2019-316060.

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Clinical introductionA 63-year-old woman recently diagnosed with lung metastasis, after routine chest radiography, was admitted to our hospital for unspecified symptoms, such as dyspnoea on minimal exertion and dry cough. Physical examination showed uncommon signs. The electrocardiogram showed sinus rhythm and incomplete left bundle branch block. Thoracic CT scan revealed bilateral lung and pleural metastases and pelvic CT showed a right femoral bone mass. Transthoracic echocardiography revealed a heterogeneous mass, lateral to the right ventricle, with pericardial effusion. Further, cardiac MRI (cMRI) was performed (figure 1A,B). Diagnosis was completed with an ultrasound-guided biopsy and histopathological examination (figure 1C,D).Figure 1(A,B) Cardiac MRI: asterisk is suggestive of fluid and the white arrow indicates fibrous encapsulation by LGE, (C) H&E stain:white arrow indicating a tumoral cell with atypical mitosis and (D) immunohistochemical staining for smooth muscle actin antibody.QuestionWhich of the following is the most likely diagnosis?Pericardial lymphoma.Pericardial leiomyosarcoma.Pericardial cyst.Secondary malignant cardiac tumour.Pericardial teratoma.

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Stankovic, Ivan, Alja Vlahovic-Stipac, Biljana Putnikovic, and Aleksandar N. Neskovic. "Distinguishing incomplete right bundle branch block in patients with arrhythmogenic right ventricular cardiomyopathy from normal variants: A potential role of Fontaine leads and Holter monitoring?" International Journal of Cardiology 157, no. 1 (2012): 148–50. http://dx.doi.org/10.1016/j.ijcard.2012.03.024.

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Liang, Weijie, Sijie Zhou, Taibin Fan, et al. "Midterm Results of Transaxillary Occluder Device Closure of Perimembranous Ventricular Septal Defect Guided Solely by Transesophageal Echocardiography." Heart Surgery Forum 22, no. 2 (2019): E112—E118. http://dx.doi.org/10.1532/hsf.2185.

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Background: Perimembranous ventricular septal defect (pmVSD) is a common congenital heart disease. Transaxillary occluder device closure of the pmVSD has been proved effective and an alternative to surgical closure. The study aimed to evaluate the immediate operation outcomes and the early and midterm follow-up outcomes of transaxillary occluder device closure.  Methods: From January 2014 to December 2017, we retrospectively analyzed the patients who underwent transaxillary device closure of the pmVSD. All patients underwent transthoracic echocardiography (TTE), chest x-ray, and electrocardiogram (ECG) before and after the procedure (before discharging). Follow-up evaluation was completed at the time of 3, 6, 12 months and yearly thereafter in outpatient setting with TTE and ECG. Results: A total of 428 patients (216 male, 212 female) underwent transaxillary occluder device closure of the pmVSD under the guidance of transesophageal echocardiography (TEE). The mean age at the operation time was 2.2 ± 1.5 year (range 0.5-16.2 year). The mean weight was 8.5 ± 4.1 kg (range 6-61 kg). The mean size of the occluder implanted in the operation was 5.3 ± 1.4 (range 4-8 mm), matching the mean defect size of 4.2 ± 1.1 (range 3-6 mm). The device closure operation was successfully achieved in 422 pmVSD patients (98.6%), and 6 patients failed in occluding and were converted to open surgery because of a great residual shunt and obvious device-related aortic regurgitation . Immediate complete closure was detected by postoperative TEE in all, but 3 patients had trivial residual shunting. Total early adverse events emerged in 47 patients (11.1%). New mild tricuspid and aortic regurgitation occurred in 17 and 3 patients and disappeared in follow-up. Abnormal atrioventricular conduction events emerged in 23 patients, including left anterior block, complete right bundle branch block (CRBBB), incomplete right bundle branch block (IRBBB), administrated with close follow-up. Pericardial effusion occurred in 2 other patients, managed with puncture drainage. During a median follow-up period of 26.8 months (range 6-48 months), no serious adverse event and later-on complete atrioventricular block were encountered. Conclusion: In our experience, transaxillary device closure was performed via right infra-axillary mini-incision (invisible) guided by TEE, with low incidence of postoperative adverse events, confirming that transaxillary device closure of the pmVSD under the guidance of TEE is an effective alternative to surgical closure in well-selected pmVSD patients.

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Zeledón, Rodrigo, João Carlos P. Dias, A. Brilla-Salazar, J. Marcondes de Rezende, Luis G. Vargas, and Andrea Urbina. "Does a spontaneous cure for chagas' disease exist?" Revista da Sociedade Brasileira de Medicina Tropical 21, no. 1 (1988): 15–20. http://dx.doi.org/10.1590/s0037-86821988000100003.

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Six Costa Rican Chagas' disease patients, with wellknown acute phase history and no specific treatment were examined in several occasions during 39, 24, 32, 16 and 14 years, respectively, from the onset. Nome of the patients presented heart abnormalities as revealed by the conventional EKG and ergometry, exceptfor one of them with an incomplete block of the right bundle branch. Also, no alterations of the oesophagus motility was detected manometrically except for another patient who presented a slight hypersensivity reaction to a pharmacological test (Mecholyl). Three out of six patients became serologically negative in 1981, remaining as such until 1986. Besides the conventional serology, the search of protective ("lytic") antibodies was also performed in 1985 and 1986, being completely negative in one of the "cured" patients and dubious in the other two. The hypothesis that these three patients had as spontaneous cure, based on the clinical, serological and parasitologica l findings is discussed.

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Xu, Hongyuan, Jinyi Li, Guoqiang Zhong, et al. "Characteristics of the Dynamic Electrocardiogram in the Elderly with Nonvalvular Atrial Fibrillation Combined with Long R-R Intervals." Evidence-Based Complementary and Alternative Medicine 2021 (November 10, 2021): 1–7. http://dx.doi.org/10.1155/2021/4485618.

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Objective. To investigate the characteristics of dynamic electrocardiogram and their clinical implications in elderly patients with nonvalvular atrial fibrillation combined with long R-R intervals. Methods. Elderly patients diagnosed with nonvalvular atrial fibrillation who were admitted as an inpatient or attended the outpatient department from January 2015 to January 2020 were selected. Patients were divided into two groups based on the presence of a long R-R interval. The characteristics and therapeutic significance of dynamic electrocardiogram between the two groups were compared. Results. A total of 532 patients were included in our analyses. Of these, 399 patients were in the long R-R interval group and 133 in the nonlong R-R interval group. In 399 patients, there were 48,840 long R-R intervals manifested within 24 hours. The average, slowest, and fastest ventricular rates during sleep time were higher than those in nonsleep time, while the number of long R-R intervals in sleep time was significantly smaller than that in nonsleep time ( P < 0.05 ). Clinical parameters including dizziness/syncope, cerebral infarction, ST-segment changes, platelet count, average hematocrit, prothrombin time (PT), left ventricular systolic function, end-diastolic diameter, pulmonary artery pressure, and left ventricular ejection fraction were comparable between the groups ( P > 0.05 ). When compared with the nonlong R-R interval group, the level of C-reactive protein was slightly lower in the long R-R interval group ( P < 0.05 ). In addition, the long R-R interval group had a higher incidence of atrial premature beats but a lower incidence of ventricular premature beats. Furthermore, the probability of long R-R interval combined with paroxysmal atrial tachycardia, transient ventricular arrest, second-degree atrioventricular block, and complete or incomplete right bundle branch block was higher than that of nonlong R-R interval ( P < 0.05 ). In patients with long R-R interval >3 s, the risk of having second-degree atrioventricular block and complete or incomplete right bundle branch block was significantly lower, while the risk of having transient ventricular arrest was higher when compared to patients with long R-R intervals of 2-3 s ( P < 0.05 P). Conclusions. Long R-R interval is a common electrocardiographic phenomenon among the elderly with nonvalvular atrial fibrillation. The long R-R interval mostly occurs in nonsleeping time. The average ventricular rate, slowest ventricular rate, and fastest ventricular rate of sleep time are higher than nonsleeping time. Analysis of the characteristics of the dynamic electrocardiogram of these patients may shed light on the mechanisms for long R-R intervals, including the likelihood of concealed conduction and physiological interference in the atrioventricular node, overspeed inhibition, increased vagus nerve tension, or pathological atrioventricular block.

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Krca, Bojana, Boris Dzudovic, Snjezana Vukotic, et al. "Association of different electrocardiographic patterns with shock index, right ventricle systolic pressure and diameter, and embolic burden score in pulmonary embolism." Vojnosanitetski pregled 73, no. 10 (2016): 921–26. http://dx.doi.org/10.2298/vsp150512011k.

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Background/Aim. Some electrocardiographic (ECG) patterns are characteristic for pulmonary embolism but exact meaning of the different ECG signs are not well known. The aim of this study was to determine the association between four common ECG signs in pulmonary embolism [complete or incomplete right bundle branch block (RBBB), S-waves in the aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads] with shock index (SI), right ventricle diastolic diameter (RVDD) and peak systolic pressure (RVSP) and embolic burden score (EBS). Methods. The presence of complete or incomplete RBBB, S waves in aVL lead, S1Q3T3 sign and negative T-waves in the precordial leads were determined at admission ECG in 130 consecutive patients admitted to the intensive care unit of a single tertiary medical center in a 5-year period. Echocardiography examination with measurement of RVDD and RVSP, multidetector computed tomography pulmonary angiography (MDCT-PA) with the calculation of EBS and SI was determined during the admission process. Multivariable regression models were calculated with ECG parameters as independent variables and the mentioned ultrasound, MDCT-PA parameters and SI as dependent variables. Results. The presence of S-waves in the aVL was the only independent predictor of RVDD (F = 39.430, p < 0.001; adjusted R2 = 0.231) and systolic peak right ventricle pressure (F = 29.903, p < 0.001; adjusted R2 = 0.185). Negative T-waves in precordial leads were the only independent predictor for EBS (F = 24.177, p < 0.001; R2 = 0.160). Complete or incomplete RBBB was the independent predictor of SI (F = 20.980, p < 0.001; adjusted R2 = 0.134). Conclusion. In patients with pulmonary embolism different ECG patterns at admission correlate with different clinical, ultrasound and MDCT-PA parameters. RBBB is associated with shock, Swave in the aVL is associated with right ventricle pressure and negative T-waves with the thrombus burden in the pulmonary tree.

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