Abstract：Five patients with complete right bundle branch block (CRBBB) and complete left bundle branch block (CLBBB) on electrocardiograms(ECGs) were observed, but vectorcardiograms(VCGs) were not consistent with ECGs. In 2 cases, the delay of regional myocardial depolarization in left ventricle combined with the prolongation of right ventricular depolarization time due to the obvious hypertrophy of right ventricle, resulting in the prolongation of QRS cycle running time and body turning forward. As a result, the shape of QRS wave was changed to “CRBBB”like shape on ECG. In three patients with ECGs showing “CLBBB”like shape, two of which were caused by nonspecific intraventricular block. The activation of the lesion on local and extensive myocardium of left ventricle(Purkinje fiber) was delayed in the left ventricular depolarization led to the nonspecific intraventricular block. The last case is due to the miocardial infarction combined with block of infarct myocardium, resulting in local conduction delay of activation on lesion location. The comparison between the ECGs and VCGs of the cases demonstrating that there is more obvious advantage of VCG on the diagnosis and identification of QRS waveform changes.
罗昭林，王春芝，徐瑛. 心电向量图在诊断及鉴别室内阻滞中的应用价值[J]. 实用心电学杂志, 2020, 29(2): 113-120.
Luo Zhaolin，Wang Chunzhi，Xu Ying. Value of vectorcardiogram in the diagnosis and identification of intraventricular block. JOURNAL OF PRACTICAL ELECTROCARDIOLOGY, 2020, 29(2): 113-120.
