Incomplete right bundle branch block in Congenital heart disease

Incomplete right bundle branch block in Congenital heart disease

Incomplete right bundle branch block seen in

[A] ASD
[B] VSD
[C] TGA
[D] TOF

Incomplete right bundle branch block in Congenital heart disease

What is the cause of Incomplete right bundle branch block [RBBB] in ASD

Incomplete right bundle branch block is attributed to

ASD – RV Volume overload – Hypertrophied outflow tract of the right ventricle – Prolonged depolarization of the hypertrophied outflow tract of the right ventricle -Incomplete RBBB

• Prolonged depolarization of the hypertrophied outflow tract of the right ventricle
• Exacerbated by volume overload in the right ventricle

‘Crochetage’ sign on ECG

Notch near the apex of the R wave in inferior limb leads – II, III, aVF
‘Crochetage’ sign on ECG in secundum ASD

Pranab Jyoti Bhattacharyya
http://dx.doi.org/10.1136/bcr-2016-217817

• Incomplete right bundle branch blocks – markers for atrial septal defects
• Crochetage sign – does not depend completely on the presence of an incomplete right bundle branch block for diagnosis
• Why it is called ‘crochetage’ – because the notch resembles the work of a crochet needle

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