{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,24]],"date-time":"2026-07-24T06:04:33Z","timestamp":1784873073255,"version":"3.55.0"},"reference-count":8,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"4","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circ: Arrhythmia and Electrophysiology"],"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:sec>\n            <jats:title>Background\u2014<\/jats:title>\n            <jats:p>Definitive diagnosis of bilateral bundle-branch delay\/block may be made when catheter-induced right bundle-branch block (RBBB) develops in patients with baseline left bundle-branch (LBB) block. We hypothesized that a RBBB pattern with absent S waves in leads I and aVL will identify bilateral bundle-branch delay\/block.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods and Results\u2014<\/jats:title>\n            <jats:p>Fifty patients developing transient RBBB pattern in lead V1 during right heart catheterization were studied. Patients were grouped according to whether the baseline ECG demonstrated a normal QRS, left fascicular blocks, or LBB block pattern. The RBBB morphologies in each group were compared. The prevalence of bilateral bundle-branch delay\/block pattern was examined in our hospital ECG database. All patients with baseline normal QRS complexes (n=30) or left fascicular blocks (4 anterior, 5 posterior) developed a typical RBBB pattern. Among the 11 patients with a baseline LBB block pattern, 7 developed an atypical RBBB pattern with absent S waves in leads I and aVL and the remaining 4 demonstrated a typical RBBB. The absence of S waves in leads I and aVL during RBBB was 100% specific and 64% sensitive for the presence of pre-existing LBB block. Among the consecutive 2253 hospitalized patients with RBBB, 34 (1.5%) had the bilateral bundle-branch delay\/block pattern.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions\u2014<\/jats:title>\n            <jats:p>An ECG pattern of RBBB in lead V1 with absent S wave in leads I and aVL indicates concomitant LBB delay. Pure RBBB and bifascicular blocks are associated with S waves in leads I and aVL.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/circep.113.000999","type":"journal-article","created":{"date-parts":[[2014,7,12]],"date-time":"2014-07-12T06:26:21Z","timestamp":1405146381000},"page":"640-644","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Electrocardiographic Features and Prevalence of Bilateral Bundle-Branch Delay"],"prefix":"10.1161","volume":"7","author":[{"given":"Leonidas","family":"Tzogias","sequence":"first","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Leonard A.","family":"Steinberg","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Williams","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kent E.","family":"Morris","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William J.","family":"Mahlow","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard I.","family":"Fogel","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeff A.","family":"Olson","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric N.","family":"Prystowsky","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Benzy J.","family":"Padanilam","sequence":"additional","affiliation":[{"name":"From the St. Vincent Medical Group, Indianapolis, IN."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1540-8167.2009.01714.x"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.12.013"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(54)90295-1"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.17.3.397"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.35.4.790"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.41.6.899"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.37.3.429"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1161\/circulationaha.110.986943"}],"container-title":["Circulation: Arrhythmia and Electrophysiology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/CIRCEP.113.000999","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T00:01:10Z","timestamp":1715558470000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/CIRCEP.113.000999"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2014,8]]},"references-count":8,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2014,8]]}},"alternative-id":["10.1161\/CIRCEP.113.000999"],"URL":"https:\/\/doi.org\/10.1161\/circep.113.000999","relation":{},"ISSN":["1941-3149","1941-3084"],"issn-type":[{"value":"1941-3149","type":"print"},{"value":"1941-3084","type":"electronic"}],"subject":[],"published":{"date-parts":[[2014,8]]},"assertion":[{"value":"2013-08-24","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-06-16","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2014-07-11","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}