de Micheli A, Medrano G A
Departamento de Electrocardiografía y Vectocardiografía, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Arch Inst Cardiol Mex. 1988 Nov-Dec;58(6):575-86.
The electro-vectorcardiographic manifestations of uncomplicated and complicated proximal and peripheral right conduction system blocks are described. In the presence of an advanced degree right bundle branch block (RBBB), the septal activation, which occurs with abnormal spreading, originates electromotive forces of greater duration and consequently of more importance than normal ones. Peripheral right blocks provoke a segmentary delay of right ventricle activation, producing asynchronism of the electrical phenomenon between upper and lower regions of the ipsilateral ventricle. The coexistence of an inactivatable anteroseptal zone with an advanced degree RBBB cause the phenomenon of "wave jumping" to begin in inferior posteroseptal regions. Therefore, the transitional leads see the first fronts of the said phenomenon moving away and register Q waves. The presence of a transmural inactivatable right parietal zone permits the corresponding external electrodes to record the morphology of the ipsilateral intraventricular complex. In certain cases a right anterior subdivision block (RASB) or a right posterior subdivision block (RPSB) can complicate with an inactivatable septal or ipsilateral septo-parietal zone, but these do not notably modify Q waves of the ventricular complex in the right leads.
本文描述了单纯性和复杂性近端及外周右传导系统阻滞的心电图表现。在存在高度右束支传导阻滞（RBBB）的情况下，间隔激活以异常扩散的方式发生，产生持续时间更长的电动势，因此比正常电动势更重要。外周右阻滞会导致右心室激活的节段性延迟，在同侧心室的上部和下部区域之间产生电现象的不同步。高度RBBB与不可激活的前间隔区共存会导致“波跳跃”现象在下部后间隔区域开始。因此，过渡导联会看到上述现象的第一个波阵面远离并记录到Q波。存在透壁性不可激活的右壁区时，相应的外部电极可记录同侧心室内复合波的形态。在某些情况下，右前分支阻滞（RASB）或右后分支阻滞（RPSB）可能会伴有不可激活的间隔或同侧间隔 - 壁区，但这些并不会显著改变右导联心室复合波的Q波。
