Alternation of right bundle branch block with beats showing normal conduction and with a less complete right bundle branch block pattern

Pacing Clin Electrophysiol. 2009 Sep;32(9):1222-6. doi: 10.1111/j.1540-8159.2009.02468.x.


We report the case of an 80-year-old man with a preexistent right bundle branch block (RBBB) who underwent dobutamine stress echocardiography. As the sinus cycle length gradually decreased during the stress test, he first developed a 2:1 RBBB pattern alternating with beats showing normal conduction and then an alternating 2:1 less complete and more complete RBBB pattern. An elucidation of the potential mechanism of the latter very rare phenomenon is provided.

Publication types

  • Case Reports

MeSH terms

  • Aged, 80 and over
  • Bundle-Branch Block / diagnosis*
  • Diagnosis, Differential
  • Electrocardiography / methods*
  • Humans
  • Male
  • Tachycardia, Ventricular / diagnosis