Wednesday, June 12, 2024

Pediatric Left Bundle Branch Block

Background

Left bundle branch (LBB) block (LBBB) occurs when transmission of the cardiac electrical impulse is delayed or fails to be conducted along the rapidly conducting fibers of the main LBB or in both left anterior and posterior fascicles.
Thus, the left ventricle slowly depolarizes by means of cell-to-cell conduction that spreads from the right ventricle to the left ventricle. This results in the characteristic electrocardiographic (ECG) pattern shown in the image below.

These electrocardiograms show a normal sinus rhyth

These electrocardiograms show a normal sinus rhythm and a sinus rhythm with a left bundle branch block.

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LBBB in children is associated with cardiovascular disease, surgery, or ablation within the left ventricle and is not observed in the general population. LBBB may occur in as many as 20% of individuals after aortic valve replacement.

See Are You Missing Subtle MI Clues on ECGs? Test Your Skills, a Critical Images slideshow, to help identify a variety of electrocardiographic abnormalities.

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