Niimi N, Sugiyama S, Wada M, Sugenoya J, Oguri H
J Electrocardiol. 1977 Jul;10(3):257-66. doi: 10.1016/s0022-0736(77)80068-x.
In order to investigate the specific sites of conduction block in the three types (I, II, III) of right bundle branch block (RBBB) classified by body surface isopotential maps, the simulation of ventricular propagation process and mathematically reconstructed maps were used. Four assumptions were introduced from the results of clinical observations and animal experiments. The maps reconstructed from two of these assumptions, in which the conduction block was placed on the main stem of the right bundle branch, showed two different patterns at late stages of excitation, and these two kinds of map resembled Types I and II in clinical maps, respectively. The maps reconstructed from the other two assumptions, in which the site of the conduction block was located mainly in the Purkinje system of the right ventricular free wall, resembled Type I at the late stage of excitation in one of two assumptions and agreed with Type III through all stages of excitation in other case. Based on the above results, it is speculated that the differences of ranges and degrees of conduction block ascribed to abnormal activation in the Purkinje system of the right ventricular free wall are responsible for the genesis of clinical RBBB map patterns.
为了研究根据体表等电位图分类的三种类型（I型、II型、III型）右束支传导阻滞（RBBB）中传导阻滞的具体部位，采用了心室传导过程模拟和数学重建图。从临床观察和动物实验结果中引入了四个假设。从其中两个假设重建的图中，传导阻滞位于右束支主干上，在兴奋后期显示出两种不同的模式，这两种图分别类似于临床图中的I型和II型。从另外两个假设重建的图中，传导阻滞部位主要位于右心室游离壁的浦肯野系统，在其中一个假设中，兴奋后期类似于I型，在另一种情况下，整个兴奋阶段均与III型相符。基于上述结果，推测右心室游离壁浦肯野系统中因异常激活导致的传导阻滞范围和程度的差异是临床RBBB图型产生的原因。
