Bilateral Bundle Branch Block (BBBB)

Report:

Sinus rhythm 94/min

Advanced (4:1) AV block

Left bundle branch block

Comment:

While it is possible that there exist independent AV nodal block and isolated LBB disease, the block as recorded is more likely an expression of BBBB, viz. permanent LBBB + 4:1 RBBB!

The block resolved spontaneously after admission (below, Fig 140a). The patient received a permanent pacemaker.

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