{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T11:11:30Z","timestamp":1775733090683,"version":"3.50.1"},"reference-count":6,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2010,2,1]],"date-time":"2010-02-01T00:00:00Z","timestamp":1264982400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Cardiovasc electrophysiol"],"published-print":{"date-parts":[[2010,7]]},"abstract":"<jats:p> <jats:bold>LBBB and Heart Block<\/jats:bold>.\u2002<jats:bold><jats:italic>Background:<\/jats:italic><\/jats:bold> Patients with left bundle branch block (LBBB) undergoing right heart catheterization can develop complete heart block (CHB) or right bundle branch block (RBBB) in response to right bundle branch (RBB) trauma. We hypothesized that LBBB patients with an initial r wave (\u22651 mm) in lead V1 have intact left to right ventricular septal (VS) activation suggesting persistent conduction over the left bundle branch. Trauma to the RBB should result in RBBB pattern rather than CHB in such patients.<\/jats:p><jats:p> <jats:bold>\n            <jats:italic>Methods:<\/jats:italic>\n          <\/jats:bold> Between January 2002 and February 2007, we prospectively evaluated 27 consecutive patients with LBBB developing either CHB or RBBB during right heart catheterization. The prevalence of an r wave \u22651 mm in lead V1 was determined using 118 serial LBBB electrocardiographs (ECGs) from our hospital database.<\/jats:p><jats:p> <jats:bold>\n            <jats:italic>Results:<\/jats:italic>\n          <\/jats:bold> Catheter trauma to the RBB resulted in CHB in 18 patients and RBBB in 9 patients. All 6 patients with \u22651 mm r wave in V1 developed RBBB. Among these 6 patients q wave in lead I, V5, or V6 were present in 3. Four patients (3 in CHB group and 1 in RBBB group) developed spontaneous CHB during a median follow\u2010up of 61 months. V1 q wave \u22651 mm was present in 28% of hospitalized complete LBBB patients.<\/jats:p><jats:p> <jats:bold>\n            <jats:italic>Conclusions:<\/jats:italic>\n          <\/jats:bold> An initial r wave of \u22651 mm in lead V1 suggests intact left to right VS activation and identifies LBBB patients at low risk of CHB during right heart catheterization. These preliminary findings indicate that an initial r wave of \u22651 mm in lead V1, present in approximately 28% of ECGs with classically defined LBBB, may constitute a new exclusion criterion when defining complete LBBB. <jats:italic>(J Cardiovasc Electrophysiol, Vol. pp. 781\u2010785, July 2010)<\/jats:italic><\/jats:p>","DOI":"10.1111\/j.1540-8167.2009.01714.x","type":"journal-article","created":{"date-parts":[[2010,2,1]],"date-time":"2010-02-01T18:55:57Z","timestamp":1265050557000},"page":"781-785","source":"Crossref","is-referenced-by-count":38,"title":["The Surface Electrocardiogram Predicts Risk of Heart Block During Right Heart Catheterization in Patients With Preexisting Left Bundle Branch Block: Implications for the Definition of Complete Left Bundle Branch Block"],"prefix":"10.1111","volume":"21","author":[{"given":"BENZY J.","family":"PADANILAM","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"KENT E.","family":"MORRIS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JEFF A.","family":"OLSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"JANET S.","family":"RIPPY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"MARY NORINE","family":"WALSH","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"NATRAJAN","family":"SUBRAMANIAN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ALEX","family":"VIDAL","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"ERIC N.","family":"PRYSTOWSKY","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"LEONARD A.","family":"STEINBERG","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2010,6,25]]},"reference":[{"key":"e_1_2_6_2_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.34.5.783"},{"key":"e_1_2_6_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.013"},{"key":"e_1_2_6_4_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.41.6.899"},{"key":"e_1_2_6_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.64.6.1271"},{"key":"e_1_2_6_6_2","volume-title":"Clinical Cardiac Electrophysiology: Techniques and Interpretations","author":"Josephson ME","year":"2002"},{"key":"e_1_2_6_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(87)80065-7"}],"container-title":["Journal of Cardiovascular Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.wiley.com\/onlinelibrary\/tdm\/v1\/articles\/10.1111%2Fj.1540-8167.2009.01714.x","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/j.1540-8167.2009.01714.x","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,10,15]],"date-time":"2023-10-15T19:45:34Z","timestamp":1697399134000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/j.1540-8167.2009.01714.x"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2010,6,25]]},"references-count":6,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2010,7]]}},"alternative-id":["10.1111\/j.1540-8167.2009.01714.x"],"URL":"https:\/\/doi.org\/10.1111\/j.1540-8167.2009.01714.x","archive":["Portico"],"relation":{},"ISSN":["1045-3873","1540-8167"],"issn-type":[{"value":"1045-3873","type":"print"},{"value":"1540-8167","type":"electronic"}],"subject":[],"published":{"date-parts":[[2010,6,25]]}}}