Implications of Left Bundle Branch Block in Patient Treatment

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Presentation transcript:

Implications of Left Bundle Branch Block in Patient Treatment Vineet Kumar, MD, Rajesh Venkataraman, MD, Wael Aljaroudi, MD, Jose Osorio, MD, Jaekyeong Heo, MD, Ami E. Iskandrian, MD, Fadi G. Hage, MD American Journal of Cardiology Volume 111, Issue 2, Pages 291-300 (January 2013) DOI: 10.1016/j.amjcard.2012.09.029 Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 1 Electrocardiographic criteria for diagnosing LBBB (see text for details). American Journal of Cardiology 2013 111, 291-300DOI: (10.1016/j.amjcard.2012.09.029) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 2 Sgarbossa's criteria for diagnosing AMI in patients with LBBB. Electrocardiogram shows discordant ST-segment elevation >5 mm in lead V3 and concordant ST-segment elevation >1 mm in leads V5 and V6. American Journal of Cardiology 2013 111, 291-300DOI: (10.1016/j.amjcard.2012.09.029) Copyright © 2013 Elsevier Inc. Terms and Conditions

Figure 3 Perfusion defect on myocardial perfusion imaging in patients with LBBB. (A) Typical perfusion defect associated with LBBB on single photon emission computed tomography imaging shown. The defect is usually located in the basal septal region and is more pronounced with exercise-induced stress (graded exercise testing), because maximum heart rate achieved is much greater compared to adenosine or regadenoson. In this example, a perfusion defect is apparent with graded exercise testing. A repeat study with adenosine showed normal perfusion. A study with the patient at rest is shown for comparison. (B) Respective polar maps shown. Blackened areas represent the perfusion defect; hatched area, denotes that perfusion abnormality is reversible. American Journal of Cardiology 2013 111, 291-300DOI: (10.1016/j.amjcard.2012.09.029) Copyright © 2013 Elsevier Inc. Terms and Conditions