Left bundle branch block classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]

Classification

New Left Bundle Branch Block

New LBBB is defined as the presence of a new left bundle branch block and:[1]

  1. A prior ECG with normal QRS duration (<110 ms)12 within 24 hours before the LBBB tracing without T-wave abnormalities.
  2. Acute-onset illness with LBBB on the admission tracing resolving within 24 hours without T-wave abnormalities on the subsequent narrow QRS tracings (to exclude LBBB lasting more than 24 hours) in patients with no history of LBBB.

Old Left Bundle Branch Block

An old LBBB is defined as an[2] LBBB that has existed for more than 24 hours (by prior tracings or reports in the electronic medical record).

Left Bundle Branch Block of Unknown Duration

The LBBB duration is unknown on tracings obtained within the first 24 hours of admission in which there is not any prior EKG information.[3]

References

  1. Shvilkin A, Bojovic B, Vajdic B, Gussak I, Ho KK, Zimetbaum P, Josephson ME. Vectorcardiographic and electrocardiographic criteria to distinguish new and old left bundle branch block. Heart Rhythm 2010;7:1085–1092.
  2. Shvilkin A, Bojovic B, Vajdic B, Gussak I, Ho KK, Zimetbaum P, Josephson ME. Vectorcardiographic and electrocardiographic criteria to distinguish new and old left bundle branch block. Heart Rhythm 2010;7:1085–1092.
  3. Shvilkin A, Bojovic B, Vajdic B, Gussak I, Ho KK, Zimetbaum P, Josephson ME. Vectorcardiographic and electrocardiographic criteria to distinguish new and old left bundle branch block. Heart Rhythm 2010;7:1085–1092.

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