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Pacing Clin Electrophysiol. 2009 Sep;32(9):1222-6. doi: 10.1111/j.1540-8159.2009.02468.x.

Alternation of right bundle branch block with beats showing normal conduction and with a less complete right bundle branch block pattern.

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Department of Internal Medicine, Semmelweis University, School of Medicine, Budapest, Hungary.


We report the case of an 80-year-old man with a preexistent right bundle branch block (RBBB) who underwent dobutamine stress echocardiography. As the sinus cycle length gradually decreased during the stress test, he first developed a 2:1 RBBB pattern alternating with beats showing normal conduction and then an alternating 2:1 less complete and more complete RBBB pattern. An elucidation of the potential mechanism of the latter very rare phenomenon is provided.

[Indexed for MEDLINE]

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