1986 Volume 6 Issue 3 Pages 257-264
We present 4 cases of rate-dependent bundle branch block (RDBBB). Tachycardia-dependent bundle branch block occurred when the heart rate exceeded a critical value after premedication or during intubation or extubation. And it reverted to normal when the heart rate decreased spontaneously or after the medication of anti-choline esterase or β-blocker. One of these cases was tachycardia- and bradycardia-dependent bundle branch block.
We are rarely aware of the depression of cardiac function when RDBBB develops. While we need not always to treat it immediately, it is important to diagnose it carefully during anesthesia for following some reasons. First, it is difficult to differentiate RDBBB from ishemic heart disease which some of RDBBB are in connection with. Second, we may mistake it for slow ventricular tachycardia and treat it inappropriately.
