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PVCs with L/R BBB shape...
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PVCs with L/R BBB shape...

Hello,

Is it correct that PVCs that have RBBB shape have clinical significant and poor progress than those have LBBB shape? Can someone send me a link with PVC with RBBB shape/pattern and PVC with LBBB shape?

Thx  
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5 Comments Post a Comment
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1124887_tn?1313758491
PVCs with RBBB shape origin from the left ventricle and vice versa. PVCs are less likely to origin from the left ventricle, because the electrical pattern in the heart is designed so the RV (more accurate: the right ventricle outflow tract) is supposed to fire an escape rhythm if the atria and AV node fails, like during complete AV block.

Concerning the pictures, you may as well google them, and you will find results. As you ask those questions, I assume you are familiar with EKG's and how to interpret them, so the way to determine is to check the precordial leads:

RBBB shape: rSR pattern in V1. LBBB shape: M pattern (RSR) in V5/V6 with inverted T wave.

It's important to realise that early PACs really often mimic PVCs with RBBB configuration. This is known as "aberrant PACs" or "Ashman phenomenon". There are ways to determine this, if you are interested. You can read more about it here:

http://library.med.utah.edu/kw/ecg/ecg_outline/Lesson5/ventricular.html

Or you can just trust your doctor :)

Take care!

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Avatar_m_tn
Will you check this PVC and let me know the PVC pattern shape.

http://www.learnekgs.com/pvc.htm
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1124887_tn?1313758491
No, can't tell just from one lead.
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Avatar_m_tn
Is what you see a typical PVC? what other PVC shapes do you frequently see or know?
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1124887_tn?1313758491
I'm no doctor and hence not an EKG expert, but what you see there is a PVC. Both LBBB and RBBB PVCs are "typical" PVCs. You need a 12 lead EKG to differ between them.
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