Fascicular Conduction Disturbances Post Re-Vascularization in Coronary Artery Disease

Volume 4, Oct 2015

Bhabani Sahoo, PG 1st year MD, Gaurav Thakre, PG 2nd year MD, B. V. Manjunath, MD, DM, Mangalore, India

 In coronary artery disease, arrhythmias are often seen post revascularization. The most common arrhythmia being accelerated idioventricular rhythm and the less common being bundle branch block, ventricular tachycardia, atrial fibrillation and others. It is a belief that most of the arrhythmias post revascularization suggest vessel patency and successful reperfusion but sometimes it may suggest on-going ischemia due to a fresh lesion or stent thrombosis. The mechanism for development of new postoperative bundle branch block and intraventricular conduction defect is presumably excessive intraoperative regional ischemia because of more collateral dependent regions, which could be predominantly transient. If intraoperative regional ischemia does contribute to the development of new left hemiblock and right bundle branch block, the extent is less, explaining both the transient nature and prognostic insignificance. In this case, we are reporting about a patient who had baseline left bundle branch block (LBBB), developed transient trifacsicular block with Mobitz type II atrioventricular block on a relatively lower heart rate recorded in one electrocardiogram and then reverted back to complete LBBB a few hours later. (J Clin Prev Cardiol. 2015;4(4):103-6)

Volume 4, Number 4 Pages: 103-6