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Any cardiologists around to explain this in simple terms?

(3 Posts)
ComeIntoTheGardenMaud Mon 17-Oct-11 11:04:15

A relative has received the hospital report of their recent ECG but it'll be a while before they can see the cardiologist for an explanation. In the meantime, can anyone translate this?

Indication BBB on ECG.

Sinus rhythm with bundle branch block rate 51 - 94 bpm

Dropped beats 366 correspond to 2AV block (Mobitz type 1)

Rare isolated ventricular ectopy

Rare superventricular ectopy

Isolated beats one slow run of 4 beats

No patient events

Sinus rhythm R bundle bunch block (RBBB)

Very many thanks!

lovetheweekends Mon 17-Oct-11 18:36:49

I will try to explain the best as I can!
I don't know how old your relative is??
I assume they must've had a 24 hour monitor or a week long event recorder?

Sinus rhythm (normal heart rhythm) with right bundle branch block rate 51-94bpm -
basically the way in which the heart beats is the electrical impulse starts from the SA node (located in the right atrium) and this causes the atrium to contract and this impulse is then received by the AV node (located between the atriums and ventricles) and this impulse is then passed into the ventricles via two bundles - left and right which supply the right and left ventricles respectively, and the ventricles then contract.
The AV node also prevents very fast impulses which can sometimes begin in the atrium (>300 per minute) to pass into the ventricles.
So with right bundle branch block the impulse does not pass down the branch which supplies the right ventricle but goes down the left bundle as normal and is then passed via the cells of the heart to the right ventricle (which takes milliseconds). This means that instead of the left and right ventricle contracting at the same the time, there is a very small delay between them.
Right bundle branch block in isolation is not a problem (some people are born with it). It is more common with advancing age, but can sometimes be as a result of an underlying heart problem.

51-94bpm (beats per minute) is pretty much within normal limits, but on the lower range, 51 is slightly low but may be during sleep.
The heart is not beating particularly fast - this would depend on what they were doing during the time of the recording, but most people's heart rates go to over 100 at least a few times a day. This could be reduced due to medication or just lack of moving around!

Dropped beats 366 (no. of beats dropped?) correspond to Mobitz Type I - this means that there is a problem with the function of the AV node and what happens is the delay between the impulse being received and then passed through the AV node into the ventricles is getting progressively longer with each beat until one impulse from the AV node is not passed to the ventricles at all (dropped beat) and then the cycle normally starts up again with the delay in the AV node getting progressively longer again until another beat is dropped.
I assume this is transient as only 366 over the course of the recording. Sometimes the AV node works normally at lower rates being received from SA node (ie. 60 beats per minute) but cannot cope with slightly higher rates (ie. 100 beats per minute or above). This can be a problem when someone is exercising (even just walking around) as the heart rate should be increasing then but will only increase up to a point as every few beats a beat is dropped.

Rare isolated ventricular ectopy / Rare superventricular ectopy - this is normal finding, we all get some occasional extra heart beats and are only a problem if you get run of them all together.

Isolated beats one slow run of 4 beats - to be honest this doesn't really make sense to me? but I will assume that it means a run of 4 slow 'ventricular' beats - generally a run of 4 beats is not a big concern, particularly if at a slow rate.

The first thing they will likely do is check the medication your relative is taking as some can cause problems with the AV node and overall conduction in the heart - particularly beta blockers, calcium channel blockers.

If your relative is asymptomatic I wouldn't worry too much at present but would hope they would be seen fairly soon.

If your relative if symptomatic, I would obviously push for an appointment ASAP!

In the longer term they might require a pacemaker.

Sorry epic post, but hope it helps
smile

ComeIntoTheGardenMaud Mon 17-Oct-11 18:49:45

Oh, thank you so much!

thanks thanks thanks thanks thanks thanks thanks thanks thanks thanks thanks thanks

I found some stuff online which defined some of the terms, but that's really helpful in explaining what it might mean. I don't want to say any more online so will take the liberty of PMing you. If that is too intrusive, don't feel you have to reply. Thanks again.

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