Transient LBBB with RAD & Prolonged Interpolation Effect
Report:
Sinus rhythm and arrhythmia
VEBs, interpolated
Sustained PR interval prolongation
Left bundle branch block
Transient right axis deviation post-VEBs
Possible old anterolateral infarction
Comment:
Two things are of interest here: diminuendo PR intervals after interpolated VEBs and increase in QRS duration – still in LBBB conduction – with RAD in the beat following the VEB. The latter is presumably due to short cycle after the interpolated VEB – a rate-dependent aberrancy. This is most unusual.
The notched QRS complex in V6 and 1 may indicate an old infarction.
The patient had a permanent 1o AV block at other times (Fig 78a); this may explain the marked, prolonged effect of interpolation on his PR intervals.
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