The ability to identify a bundle branch block pattern on the ECG, and to assess its clinical relevance, is a key skill in general medicine. In this course, we will teach you how to distinguish between complete right bundle branch block and complete left bundle branch block on the ECG. We will show you the abnormal events in the heart which are thought to produce the predictable ECG changes associated with both of these entities. We teach you how to identify right- and left-incomplete bundle branch block on the ECG. You will also learn how to identify ECG patterns believed to reflect damage to multiple components of the cardiac conducting system; bifascicular and trifascicular block. We will teach you how to identify the likely site of origin, within the ventricles, of a premature ventricular contraction.
Planner and Author: Dr John Seery MB PhD
Planner: Dr Karen Strahan PhD (University of Cambridge), Head of Editorial
Planner: Tommy O'Sullivan, CME Manager
Upon successful completion of this activity, you will be able to:
Participants must complete the online activity during the valid period as noted above.
Follow these steps:
Acadoodle adheres to the ACCME's Standards for Integrity and Independence in Accredited Continuing Education. Any individuals in a position to control the content of a CE activity, including faculty, planners, reviewers or others are required to disclose all relevant financial relationships with ineligible entities (commercial interests). All relevant conflicts of interest have been mitigated prior to the commencement of the activity.
Planners and faculty for this activity have no relevant financial relationships with commercial interests to disclose.
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Schamroth L and Bradlow BA. Incomplete left bundle-branch block. Br Heart Journal. 1964;26:285-8.
Bussink BE et al. Right bundle branch block: prevalence, risk factors, and outcome in the general population: results from the Copenhagen city heart study. Eur Heart J. 2013;34(2):138-46.
Fernandez-Lozano I and Brugada J. Right bundle branch block: are we looking in the right direction? Eur Heart J. 2013;34:86–8.
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Almeida ND et al. Cardiac Resynchronization Therapy in Heart Failure: Do Evidence-Based Guidelines Follow the Evidence? Circulation. 2017;10
Shetty RK et al. Trifascicular block progressing to complete AV block on exercise: a rare presentation demonstrating the usefulness of exercise testing. BMJ Case Rep. 2015; bcr2014209180. doi:10.1136/bcr-2014- 209180.
Leighton R et al. Incomplete Left Bundle-Branch-Block: The View from Transseptal Intraventricular Leads. Circulation. 1967;36:261-74.
Fukuda K et al. Histopathological Study on the Conduction System of Complete Right Bundle Branch Block with Special References to Configuration of QRS Complex. Jap Heart J. 1979;20(6):83-44.
Tomita M et al. A complete right bundle-branch block masking Brugada syndrome: a case. J Electrocardiol. 2012;45(6):780-2.
Acadoodle, Ltd is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
Acadoodle, Ltd designates this enduring material activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.