Bundle Branch Block Quiz Part 3
Identify the following bundle branch blocks.
1.
2.
3.
4.
5.
6.
7.
Answers
1.
The right V1 lead show an RSR pattern but the QRS complex is less than 0.12 sec. making it an incomplete right bundle branch block. The R waves in the left chest leads of I, V5, V6 demonstrate normal activation of the left ventricle while the deep S wave demonstrates slower activation of the right ventricle.
2.
In lead I the tall wide broad R wave is characteristic of a left bundle branch block. As the impulse travels away from the positive electrode of lead I it causes an initial negative Q wave. After activation of the right ventricle, the electrical impulse travels from right to left across the myocardium and back towards the positive electrode and produces the positive R wave.
3.
Lead V1 shows and RSR pattern with a QRS complex greater than 0.12 sec. The movement of the impulse it initially toward the positive electrode of V1 and produces the initial R wave. As the current moves away from V1 to depolarize the left ventricle, an S wave is produced. As the current flows from left the left ventricle into the right ventricle and towards the positive electrode of V1, a second, broader,R wave is inscribed.
4.
Lead 1 is a left chest lead that shows a monophasic R wave with a broad QRS complex over 0.12 sec. In V5 and V6, the initial R wave represents activation of the right ventricle but as the electrical impulse travels from right to left across the myocardium, the deep S wave is produced.
5.
Lead 1 is a left chest lead that shows a broad, notched R wave with a QRS complex over 0.12 sec.
6.
The broadened RSR pattern in V1 makes this a right bundle branch block
7.
There is an RSR pattern to the QRS complex of V1. The second R wave is very broad and is followed by a deep, slurred S wave revealing the delayed right ventricular activation. There is also a 1st degree AV block present.
1.
4.
Answers
1.
|
| Incomplete right bundle branch block |
The right V1 lead show an RSR pattern but the QRS complex is less than 0.12 sec. making it an incomplete right bundle branch block. The R waves in the left chest leads of I, V5, V6 demonstrate normal activation of the left ventricle while the deep S wave demonstrates slower activation of the right ventricle.
2.
|
| Left bundle branch block |
In lead I the tall wide broad R wave is characteristic of a left bundle branch block. As the impulse travels away from the positive electrode of lead I it causes an initial negative Q wave. After activation of the right ventricle, the electrical impulse travels from right to left across the myocardium and back towards the positive electrode and produces the positive R wave.
3.
|
| Right bundle branch block |
Lead V1 shows and RSR pattern with a QRS complex greater than 0.12 sec. The movement of the impulse it initially toward the positive electrode of V1 and produces the initial R wave. As the current moves away from V1 to depolarize the left ventricle, an S wave is produced. As the current flows from left the left ventricle into the right ventricle and towards the positive electrode of V1, a second, broader,R wave is inscribed.
4.
|
| Left bundle branch block |
Lead 1 is a left chest lead that shows a monophasic R wave with a broad QRS complex over 0.12 sec. In V5 and V6, the initial R wave represents activation of the right ventricle but as the electrical impulse travels from right to left across the myocardium, the deep S wave is produced.
5.
|
| Left bundle branch block |
Lead 1 is a left chest lead that shows a broad, notched R wave with a QRS complex over 0.12 sec.
6.
|
| Right bundle branch block |
The broadened RSR pattern in V1 makes this a right bundle branch block
7.
|
| Right bundle branch block |
There is an RSR pattern to the QRS complex of V1. The second R wave is very broad and is followed by a deep, slurred S wave revealing the delayed right ventricular activation. There is also a 1st degree AV block present.
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