CARDIAC INFARCTION WITH BUNDLE BRANCH BLOCK

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Abstract
Sixty cases with a history or other evidence of infarction and an ecg. showing bundle branch block were analyzed. Thirty-three were of the left and 27 of the right var. Ecg. signs of infarction were present in 41 cases (68%) and appeared in 48% of cases of left block and 93% of right block. As a corollary, signs of infarction were suppressed in half the cases of left bundle branch block. The belief that significant Q-waves in left ventricular surface leads in cases with left bundle branch block denote septal infarction is supported by limited necropsy evidence. In left bundle branch block signs of infarction were revealed as often with standard limb leads as with chest or V limb leads. In right branch bundle block signs of anterior infarction were sometimes seen only in chest leads. Posterior infarction signs were confined to standard limb leads and to VF, whether the block was in the right or the left bundle branch.