LBBB & Hyperkalæmia
Report:
Junctional rhythm 57/min
VEBs
Left axis deviation
Left bundle branch block
Tall T waves consistent with hyperkalæmia
Comment:
The QRS narrowed to a left anterior hemiblock and the T waves normalised as potassium level came under control (Fig 216a below). Junctional rhythm persisted until the patient died.
The LBBB in the original trace has typical sharp descent and slower rise in V1 attesting to its supraventricular provenance. Its LAD is only reported because the conduction reverted to LAHB later; its one of those “divisional” LBBBs, with preponderant pathology in the anterior superior division of the bundle branch.
The VEBs are probably part of an accelerated idioventricular rhythm.
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