Transient disappearance of complete right bundle branch block during exercise in a patient with old inferior wall myocardial infarction.

To date, there has been no report of temporary disappearance of right bundle branch block (RBBB) during exercise. A patient with old infero-posterior myocardial infarction is described in whom complete RBBB disappeared transiently during treadmill exercise testing. No chest pain or significant ST-T changes occurred during and after the exercise periods. Any of the following mechanisms could have been involved: (1) the patient's complete RBBB might have been bradycardia-dependent, (2) an exercise-induced increase of sympathetic tone might have produced a temporary improvement of the conduction disturbances, or (3) the exercise might have elicited conduction disturbances in the main left bundle branch, which could have concealed a conduction delay in the main trunk of the right bundle branch.