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European Heart Journal Advance Access originally published online on August 30, 2008
European Heart Journal 2008 29(19):2319-2320; doi:10.1093/eurheartj/ehn391
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org

The QRS configuration during bundle branch block. What has rate got to do with it?

Hein J. Wellens*

Cardiovascular Research Institute Maastricht, 21 Henric van Veldekeplein, 6211 TG, Maastricht, The Netherlands

* Corresponding author. Tel: +31 433215440, Fax: +31 43 3261903, Email: hwellens@xs4all.nl

This editorial refers to ‘Rate-related changes in QRS morphology in patients with fixed bundle branch block: implications for differential diagnosis of wide QRS complex tachycardia’{dagger} by T. Datino et al., on page 2351

Footnotes

The opinions expressed in this article are not necessarily those of the Editors of the European Heart Journal or of the European Society of Cardiology.

The first 10% of the full text of this article appears below.

Bundle branch block is a common cause of a widened QRS complex, and, as indicated in Table 1, different mechanisms may be responsible. Three are rate related and one is based upon retrograde invasion into the bundle branch. Those four mechanisms lead to the intermittent appearance of a bundle branch block pattern.1


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  		Table 1 Types and mechanisms of bundle branch (BB) block

 
Most commonly, bundle branch block is continuously present, so-called fixed bundle branch block, the patient showing a wide QRS all the time independent of the heart rate. When the heart rate is fast and the . . . [Full Text of this Article]


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Related articles in EHJ:

Rate-related changes in QRS morphology in patients with fixed bundle branch block: implications for differential diagnosis of wide QRS complex tachycardia
Tomás Datino, Jesús Almendral, Esteban González-Torrecilla, Felipe Atienza, Francisco J. García-Fernández, Ángel Arenal, Leonardo Atea, and Francisco Fernández-Avilés
EHJ 2008 29: 2351-2358. [Abstract] [FREE Full Text]