Denes P, Pick A, Miller R H, Pietras R J, Rosen K M
Ann Intern Med. 1978 Jul;89(1):55-7. doi: 10.7326/0003-4819-89-1-55.
We reviewed electrocardiograms of 23 patients with intermittent left bundle-branch block. A characteristic electrocardiographic pattern consisting of right and mid-precordial deep symmetrical T-wave inversions was detected during normal conduction in 19 of the 23. Of the seven patients who had cardiac catheterization, only two had findings suggestive or organic heart disease and only one had significant obstructive coronary disease. Thus we conclude that patients with intermittent left bundle-branch block frequently have T-wave inversions in right and mid-precordial leads during normal conduction that do not necessarily reflect coronary disease. These T-wave changes are similar to those after termination of chronic right ventricular pacing (left bundle-branch pattern), suggesting that both patterns of abnormal ventricular activation can produce abnormal repolarization when activation returns to normal.
我们回顾了23例间歇性左束支传导阻滞患者的心电图。在23例中的19例正常传导期间，检测到一种特征性心电图模式，包括右胸前导联和胸前中部导联的深对称性T波倒置。在接受心导管检查的7例患者中，只有2例有提示器质性心脏病的表现，只有1例有严重的阻塞性冠状动脉疾病。因此，我们得出结论，间歇性左束支传导阻滞患者在正常传导期间，右胸前导联和胸前中部导联经常出现T波倒置，这不一定反映冠状动脉疾病。这些T波变化类似于慢性右心室起搏终止后（左束支模式）的变化，表明当激活恢复正常时，两种异常心室激活模式均可产生异常复极。
