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Bundle branch block ivcd1/11/2024 Typical RBBB shows wide S-wave in the lateral lead 1 and aVL, while atypical RBBB pattern lacks S-wave in lead 1 and aVL, and coexisting left-axis deviation, and may be associated with coexisting PR prolongation due to delayed activation over the left bundle. An atypical RBBB may identify possible CRT responders.Published data from the National Cardiovascular Data Registry’s ICD Registry showed that CRT was associated with better outcomes than implantable cardioverter-defibrillator (ICD) therapy alone in IVCD patients with a QRS duration ≥150 ms, but not in patients with QRS duration Despite some positive results from such studies, widespread clinical application of detailed electrical mapping is limited given its time consumption and invasive nature. Intracardiac mapping studies show that 20-50% of patients who have an IVCD may have significant delay of activation in the left lateral ventricle.
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