The Cardiovascular Atlas

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$Figure 1. Aberrant conduction. The figure shows a supraventriclar extrasystole (an extra atrial impulse, discharged by an ectopic focus outside of the sinoatrial node). The supraventricular extrasystole arrives into the ventricles while the right bundle branch is still refractory, which is why it blocks the impulse. The resulting QRS-complex has a right bundle branch block pattern.$

Aberrant ventricular conduction

Abnormal Global Longitudinal Strain (GLS), left ventricle, left atrium, abnormal tissue doppler imaging (TDI)

Action potentials

ECGs showing acute STEMI in two patients with severe chest pain. STEMI = ST elevation Myocardial Infarction.

Acute STEMI (ST elevation myocardial infarction)

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Alternative lead systems

Anatomy of the mitral valve

Anterior STEMI with late presentation

Antiplatelet therapy in acute coronary syndromes (NSTEMI, STEMI, UA)

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Antithrombotic Regimens in Patients with ACS and an Indication for Oral Anticoagulation

Antithrombotic Regimens in Patients with ACS without an Indication for Oral Anticoagulation

Aortic regurgitation (AR), severe, infective endocarditis

Aortic stenosis (AS) and mitral stenosis (MS) secondary to radiation therapy

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CVD Atlas

Figure 1. ECG characteristics and differences between normal conduction, left bundle branch block (LBBB) and right bundle branch block (RBBB).

Dr Araz Rawshani, MD, PhD

Associate professor Department of Cardiology, Sahlgrenska University Hospital, Sweden Institute of Medicine, Department of Molecular and Clinical Medicine, Gothenburg, Sweden

More by Dr Araz Rawshani, MD, PhD

Figure 1. These ECGs show the difference between normal conduction, left bundle branch block (LBBB) and right bundle branch block (RBBB). As evident from these ECGs, the cardinal difference between normal conduction and bundle branch blocks is the QRS duration: bundle branch blocks are caused by dysfunctional bundle branches, which results in slow (and abnormal) activation of ventricular myocardium and thus prolonged QRS duration. A QRS duration of 120 ms (0.12 s) is required to diagnose bundle branch block. Also note that both left bundle branch block (LBBB) and right bundle branch block (RBBB) cause marked ST-T changes, including ST elevations, ST depressions and inverted (negative) T-waves. These ST-T changes are due to abnormal repolarization and they are expected to occur in both LBBB and RBBB. Finally, note that there are marked difference in the ECG pattern between LBBB and RBBB. These ECGs are printed at paperspeed 50 mm/s.