On Genesis of RBBB Pattern in Electro- and Vectorcardiogram as Studied by Simulation of Ventricular Propagation Process and Reconstruction of QRS Patterns
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概要
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1. The ventricular propagation process in the right bundle branch block (RBBB) was simulated in the ventricular model stored in digital computer and its QRS complexes were reconstructed mathematically. The block was established in the model by laying a lesion on different levels along the right side of the specialized conducting system in different fashions. In total, five different assumptions in regard to the site and fashions of block were adopted, each of which corresponded to one of interpretations of RBBB obtained from animal experiment. 2. QRS complexes reconstructed from the assumptions where a conduction block was placed on the main right bundle branch showed R configuration in lead V_1 and QrS in lead V_5. These complexes displayed a significant changes in the initial parts in comparison with the normal simulated ones. It suggested that the rather little alteration in the initial parts of QRS complexes in clinical RBBB can not be explained by the lesion laid on the main right bundle branch. On the other hand, QRS complexes reconstructed from the assumption that excitation conducts through the main right bundle branch without block but the Purkinje system in the right ventricular free wall was not utilized for the conduction showed rsR' configuration in lead V_1 and qRs in lead V_5, not showing discernible change in their initial parts. 3. Based on the above results it was proposed that the QRS patterns in clinical RBBB is not attributable to the block at the main right bundle branch but a likely cause for the pattern is the conduction block at the level distal to the main right bundle branch along the right specialized conduction system.
- 社団法人日本循環器学会の論文
- 1968-12-20