Complete blockade of the bundle branch. Causes of complete blockade of the right bundle branch

Almost every one of us, having received a recording of an electrocardiogram in our hands, will try to decipher it ourselves and will certainly look at the conclusion written by the cardiologist. It’s good if no suspicious terms are found there, but even in the midst of complete well-being and in the absence of at least some “heart” symptoms, the entry about the blockade cannot but raise alarm bells.

It is clear that such a phenomenon will cause concern, because something is blocked in the very heart - the main organ that provides nutrition to our entire body. However, not every blockade is considered a disorder; there are also types that not only do not interfere with normal life, but also fit completely into the norm. Incomplete (partial) blockade of the right bundle branch (RBBB) is exactly the case when panic is unnecessary, however, other types of similar intracardiac blocks should not be ignored.

When reviewing the cardiography report, the patient may find there a record of blockade of any of the bundle branches (BBB). This disorder can be asymptomatic and is diagnosed by recording a cardiogram, but a detailed examination of the majority of its owners reveals deviations not only of a functional, but also of an organic nature.

The attitude towards bundle branch blocks is ambiguous: some of their varieties are considered a variant of the norm, others are always a serious problem, fraught with serious complications, which is why cardiologists pay close attention to this type of disorder, and the patient is subjected to a comprehensive examination.

cardiac cycle; the bundle branches provide impulse conduction through the ventricles of the heart

The conduction system of the heart is a kind of modified muscle cells that, during development, acquired the ability to transmit electrical signals to cardiomyocytes. Thanks to the coordinated and consistent work of the components of these pathways, the heart contracts rhythmically.

The His bundle provides excitatory nerve signals to the ventricular myocardium. It originates from the atrioventricular junction, then goes at the top of the interventricular septum, below it branches into the right and left legs (RV). The left leg (LBP) gives off anterior and posterior branches to the left ventricular myocardium. The right (PNPG), accordingly, ensures conduction in the myocardium of the right ventricle. The final link of the pathways are small Purkinje fibers, carrying signals to the main pump of our body and scattered throughout the muscle to its most remote areas.

An obstacle to the flow of a nerve impulse can appear in any part of the ventricular myocardium, provoking a block in one leg, one of the branches of the left bundle branch, or two legs at the same time. The volume of the block determines the symptoms - from its absence to total conduction disorder and severe arrhythmia.

Causes and types of ventricular blocks

The extent of damage to the nerve pathways determines type of blockade:

• Single-bundle - signal transmission along the right branch of the His bundle, one of the branches of the left, is difficult;
• Two-bundle - the branches of the left leg are blocked or the right leg is blocked with one of the branches of the left;
• Three-bundle - all three pathways are involved at once.

Blockage of a section of fascicle fibers occurs full And incomplete. With partial, only one of the branches suffers, but the work of the rest is preserved. The myocardium receives signals from another source in a roundabout way, but they are somewhat delayed.

Depending on the course of the blockade, it can be constant,transitory And intermittent. An intermittent blockade appears and disappears, which can be observed during the recording of one cardiogram. A transient conduction disorder is visible on a fragment of the electrocardiogram. Sometimes during the recording of the cardiogram, a change in the block of different branches and legs can be observed - alternating blockade.

Defined 3 degrees of NPG block:

1. In the first degree, signals reach cardiomyocytes with a delay.
2. In the second case, some of the signals do not reach the muscle tissue.
3. With a total third-degree block, nerve signals do not go to the ventricular myocardium, so it contracts on its own at a very low frequency.

Blockade of the ventricular tract is not an independent disease. This is a manifestation of another pathology. Quite often, in completely healthy people, incomplete blockade of PNPG is detected, which is considered normal.

The reasons for the appearance of conduction block in the heart are very diverse. Among them are heart problems, the use of certain medications, electrolyte imbalance, autonomic and hormonal disorders.

Cardiac causes that provoke block of His bundle fibers are:

• - acute in the form of necrosis () or chronic with scar growths in the myocardium ();
• - abnormalities in the septa of a congenital nature, narrowing, insufficiency of the valve openings, coarctation of the aorta;
• Previous cardiac surgery;
• Thickening of the left ventricle with.

The following are indicated as extracardiac factors causing block:

1. Medicinal effects - long-term use and without specialist supervision, which can be abused by cardiac patients;
2. Shifts ;
3. Smoking, alcoholism;
4. Endocrine pathology;
5. Prolonged hypoxia and dilatation of the right half of the heart in bronchopulmonary diseases (asthma, bronchitis).

If the underlying cause of bundle branch block is not determined through a comprehensive examination, the disorder is referred to as an idiopathic disorder.

As mentioned, incomplete blockade of the right bundle branch is often the norm, if no other changes are found in the organ. It is often detected in childhood and adolescence and can occur in combination with minor anomalies - open interatrial window.

Video: a cardiologist’s opinion on incomplete right bundle branch blocks in children

Unlike disorders associated with changes in conduction along the right leg, blockades of the branches of the left are ALWAYS caused by structural lesions of the heart, therefore not considered as a natural state.

One of the main mechanisms for the formation of pathological blockade is a mechanical obstacle to the propagation of a nerve signal, in particular, the proliferation of connective tissue during hypoxia and hypertrophy of the heart chambers. Another important link in pathogenesis can be considered dilatation of organ cavities during chronic insufficiency.

So, despite the possible harmlessness (with local detection of incomplete RBBB), damage to the right leg can also accompany pathology that occurs with excessive load and dilatation right half of the organ(cor pulmonale, ischemia, tricuspid valve insufficiency).

Blockade of the left bundle branch is detected in cardiosclerosis due to atherosclerotic blockage of the heart arteries, defects of the aortic valves, necrosis and inflammation of the myocardium, which contribute to changes in the left half of the heart.

Symptoms of bundle branch blocks

If the distribution of nerve signals along the components of the His bundle is difficult, symptoms may be absent, and if they are present, they are usually caused by the disease that was the root cause of the formation of the block and are extremely nonspecific. In other words, it is impossible to guess from the symptoms the type of conduction disorder, and in some cases it is even extremely difficult to suspect the presence of a blockade.

Incomplete (partial) blockade, difficulty in propagating signals along one of the branches, provided the others are functioning, does not cause subjective symptoms. This is an ECG finding that prompts further testing. Some patients experience difficulty breathing, pain in the heart, interruptions in its rhythm, fatigue, which, however, do not have a direct connection with the intraventricular block, but characterize a specific disease.

Symptoms of complete blockade speakers:

• Feeling of irregularity in heart function, palpitations;
• Dizziness, fainting;
• Chest pain.

When LBP is blocked, patients feel dizziness, heart pain, and palpitations. This leg is completely blocked in severe disorders - acute large-focal infarction, cardiomyopathy.

Blockade of three branches at the same time can be complete or incomplete. With partial blockade of conduction, some of the signals still reach the cardiomyocytes through intact fibers, but with a delay; with complete blockade, the ventricular myocardium contracts due to ectopic foci located outside the conduction pathways, and the ventricles lag significantly behind the atria.

The low frequency of ventricular contractions does not allow the organ to provide normal hemodynamics, and among the symptoms, dizziness and episodes of loss of consciousness due to inadequate cerebral circulation come first. Against the background of heart failure, sudden cardiac arrest may occur, leading to the death of the patient.

Blockade of the bundle branches is dangerous due to organ failure, repeated attacks with a risk and possible predisposition to heart attack due to a decrease in blood delivery through the coronary arteries, even without atherosclerosis developing in them.

The consequences of intraventricular block can be paroxysmal tachycardia, ventricular fibrillation, cardiac arrest. With a prolonged block, the systemic blood flow suffers with an increase in congestion in the organs. Thromboembolism is considered a dangerous complication, for the prevention of which special treatment is indicated.

ECG for bundle branch blocks

The most informative way to identify intraventricular blockades is electrocardiography, which shows changes characteristic of the pathology. Certain forms of conduction disorders are diagnosed using Holter monitoring. Diagnosing PNH blockades is not an easy task, so it is better to entrust it to a specialist, but we will try to understand a little about what and why deviations occur on a regular ECG.

Normally, the distribution of the electrical wave goes evenly from the atrial myocardium to the ventricular myocardium and from left to right, without encountering any obstacles anywhere. The passage of nerve signals from the septum to the farthest parts of the heart muscle in healthy people lasts less than 120 ms. When blocked, its transmission is inhibited, which means that the depolarization of the ventricular myocardium will also be slowed down. As a result, the muscle needs more time to depolarize and contract, which means the ventricular QRS complex will lengthen.

The expansion of the ventricular complex to 0.12 seconds or more indicates that nerve signals do not arrive through the main LES, but by a roundabout route; accordingly, the ventricles contract with a delay.

When the cardiogram shows the correct sinus rhythm along with the phenomena of fascicular blockade, then the P wave is preserved in front of all QRS, indicating that the source of contractility is the sinus node, from where the atria are excited. With ectopia of the source of contractility in the ventricular myocardium, these teeth will not exist.

Video: lesson on ECG for LES blockades

Right bundle branch block on ECG

Right bundle branch block (RBBB) is perhaps the most common finding during cardiography in athletes; it occurs in many healthy people, in people who do not suffer from cardiac pathology. However, it is usually incomplete and asymptomatic. With excessive load and dilatation of the right chambers of the organ in conditions of cardiac or pulmonary pathology, the block acquires abnormal features.

If signal transmission along the PNPG is difficult, the right ventricular myocardium and part of the septum receive signals from the LPPG, but excitation reaches here later. With incomplete RBBB, signals travel along the leg, but for a longer time than normal, so the ventricular complexes have an unusual appearance, but have a normal width.

RBBB on ECG

With complete right bundle branch block, the septum depolarizes in the correct direction, from left to right. The cardiogram shows an R wave in V1 and a Q wave in the sixth (left ventricular). After the septum has received its impulse, the excitation of cardiomyocytes is distributed throughout the left ventricular myocardium, and the ECG shows an S wave in the first chest lead and an R wave in the sixth lead.

When the left ventricle is already covered by contraction and enters systole, the signal reaches the right ventricle, which depolarizes later, and on the ECG one can observe an additional R in the I precordial lead and a deep S in V6. This is how a specific form of the ventricular complex, RSR1, is formed.

Manifestations of RBBB include:

• QRS expansion up to 120 ms or more;
• change in the outlines of the QRS: in V1-2, jaggedness of RSR1 is visible;
• the axis of the heart deviates to the right;
• high-amplitude and widened R in the first chest, wide S in the first and left ventricular leads.

Left bundle branch block on ECG

Complete or partial blockade of LBP is almost always a problem associated with structural changes in muscle tissue. With this disorder, signal transmission along the LBP does not occur, which is why the septum is depolarized in the opposite direction - from right to left. The ECG shows a Q wave in chest lead I and a small R wave in V6.

LBBB on ECG

The right ventricular myocardium is the first to depolarize, then the excitation moves to the entire left ventricular section - R appears in the I chest lead and S in V5-6 in the form of a notch. As the left chamber contracts, S appears in the first chest lead, and an additional R appears in the sixth.

The most indicative picture of LBBB is observed in the sixth chest lead, which is responsible for the functioning of the left half of the organ. Here you can see a long and distorted QRS with a jagged apex, similar to the letter M or W.

About a complete block of the left bundle branch they will say:

• wide, deformed, W-shaped ventricular complexes with a width of 120 ms in the first standard and left chest leads;
• widened and deep S in the III and first chest leads;
• absence of Q in the left precordial leads;
• the ST segment and T wave are located opposite to the direction of the main ventricular wave;
• the electrical axis is shifted to the left.

Incomplete blockade of the left bundle branch occurs when the signal does not pass through one of the branches of the bundle. The cardiogram will show changes similar to those of a complete block, but the QRS will not lengthen.

A block of the anterior branch of the left ventricle can occur in certain localizations of the infarction, sclerosis and pathology with severe thickening of the left ventricular myocardium - hypertension, some defects, dystrophy and inflammation.

For blockade of the anterior branchLNPG a significant left-sided direction of the heart axis is indicative; the lengthening of the ventricular complex is subtle or not visible. The S wave is high-amplitude in the left chest leads, becoming jagged.

Blockade of the posterior branch of the LBP gives a right-sided location of the axis, some widening of the QRS, deepening of S in the left leads. It appears with infarctions of the posterior wall and diaphragmatic part of the left ventricle, cardiomyopathies and inflammation.

Difficulties in identifying intraventricular tract blocks are often caused by their combination with other cardiac pathology, which gives significant ECG signs - infarction, hypertrophy, etc., but it is important to remember one feature: with blockades of the legs, a Q wave does not appear in those leads that characterize the blocked leg . If this tooth appears in them, then there is every reason to suspect necrosis of the heart muscle due to conduction block.

Two- and three-bundle bundle branch blocks on ECG

In some cases, a block of two pathways occurs at once. The combination of blockade of the PNPG and the anterior branch of the left leg causes prolongation of the QRS complex to 0.12 seconds, the appearance of a notch on the S wave, T inversion and deviation of the cardiac axis to the left.

In the case when RBBB is combined with damage to the posterior branch of the LBP, the heart axis is directed to the right, and the ECG can show the signs described above for each type of block. This conduction disorder indicates deep and severe changes in the heart muscle.

In case of partial disruption of conduction in three branches of the intraventricular tract at once, the ECG diagnoses atrioventricular block of the first or second degree. In the first degree, conduction deteriorates, but all impulses reach the ventricular muscle, and in the second, some impulses and, accordingly, ventricular contractions are lost.

If the three-fascicle block is complete, then the impulse from the atria does not pass to the ventricular myocardium, a complete third-degree AV block develops, in which the atria and ventricles contract uncoordinatedly, in different rhythms. The ventricular rhythm is irregular and rare, decreasing to 40 per minute.

Diagnosis and treatment of intraventricular blockades

The doctor receives the bulk of information about the degree of conduction disturbance along the His bundle and its branches from the ECG described above, because it is impossible to listen to it or determine it based on symptoms. To clarify the diagnosis, a transesophageal ECG recording can be performed.

If the blockade has developed against the background of organic changes in the heart, then the patient is shown an ultrasound examination; if necessary, MRI and scintigraphy can be performed.

Treatment of intraventricular blocks is nonspecific and is aimed at the main disease that caused conduction disorders. If the blockade is partial and does not cause any symptoms, then observation with periodic ECG monitoring is sufficient.

for lipid metabolism disorders - simvastatin, atorvastatin;

Diuretic and cardiac glycosides for chronic heart failure - indapamide, veroshpiron, digoxin;

Antibiotics and anti-inflammatory in case of myocarditis.

For severe disturbances of intraventricular conduction with frequent attacks of loss of consciousness and cerebral ischemia, surgical treatment consisting of installation is indicated. Temporary cardiac pacing is performed in the first two weeks of myocardial infarction when combined with a total left-sided blockade.

If a blockade of the intraventricular system is diagnosed, it is worth thinking about leading a healthy lifestyle, even if it is an incomplete RBBB with an asymptomatic course. Dosed physical activity is an indispensable condition for asymptomatic blockade.

In the case of an existing cardiac pathology that has caused a two- or three-fascicle blockade, the patient should exclude stressful situations, psycho-emotional and physical overload, and bad habits. It is important to rest more, normalize your diet and routine.

The issue of compatibility of bundle branch blocks and sports worries many parents and adult athletes. It happens that impaired conductivity is discovered by chance, when the patient is completely well. The question regarding playing sports in such cases should be decided by a cardiologist.

Incomplete RBBB is detected in almost a third of athletes and, in the absence of changes in the heart itself, cannot be a reason to stop playing sports. However, dynamic monitoring still won’t hurt.

According to the recommendations of experts, PNH blockades that are asymptomatic, do not impair the function of the atrioventricular node and do not provoke arrhythmias should not be an obstacle to sports. In the case of arrhythmia diagnosed by echocardiography of structural changes in the valves and myocardium, physical activity should be limited. In case of severe rhythm disorders, sports are completely excluded.

The prognosis for intraventricular tract blockades depends on the degree of the block. In the case of an asymptomatic course, it can be considered favorable, but with the development of arrhythmia against the background of an existing organic cardiac pathology, it is always serious. Heavy blockades can be deadly, creating risk of sudden death.

Impaired conduction can contribute to hemodynamic disorders due to reduced myocardial contractile activity and stroke volume, resulting in reduced blood delivery to the heart and other internal organs. All patients with bundle branch block should be examined as fully as possible, if necessary, consult with an arrhythmologist, after which all recommendations of the attending physician should be followed to prevent dangerous complications.

Video: lesson on bundle branch blocks on ECG

Bundle of His is a system of fibers through which nerve impulses travel to the heart muscle. This phenomenon ensures normal heart rhythm. And if you have been diagnosed on a cardiogram: blockade of the anterior branch of the left bundle branch, this means that the heart has stopped working with a normal rhythm, and the heart rate has deviated from the norm.

Blockage of the anterior branch occurs in the following diseases:

Congenital heart defect;

Chronic ischemic heart disease, widespread cardiosclerosis is observed in the anterior wall of the left ventricle;

Cardiopathy and myocarditis of various origins;

Left ventricular hypertrophy with sclerotic and dystrophic changes;

Dilatation of the left ventricle, which leads to distension due to aortic valve insufficiency;

Diabetes and obesity.

Statistics show that blockade of the anterior branch is present in every 75 patients aged from forty to seventy-five years, and most often this is only one observable sign of myocardial damage. If such a heart condition is diagnosed in people with pronounced heart diseases, then this indicates pronounced changes in the myocardium.

Symptoms of the disease:

-symptoms are very mild. Often they are not present at all, and the disease is discovered using a cardiogram during an examination completely by accident;

- arrhythmia of heart tone and pulse. But such symptoms are very mild, and the disease cannot be determined from them;

In newborns, this pathology occurs when congenital changes in the interventricular septum.

In older people, blockade may appear due to the aging of the body, because the cells of the heart and blood vessels also age, like the entire body as a whole. Therefore, older people complain that almost all their organs hurt. And sometimes such patients mistake the symptoms of another disease for symptoms of a blockade, but the prognosis here is quite favorable.

Treatment

Usually, anterior branch block does not require special treatment. Patients who are found to have abnormalities in the electrical axis during examination are treated for the underlying disease and, if possible, the manifestations of the blockade are eliminated. In severe cases, patients are prescribed aminophylline, atropine or aminophylline. Sometimes this condition requires treatment using ventricular pacing.

In order to understand what left ventricular block is, you need to know how a healthy human heart works, as well as how its conduction system is organized.

Our heart consists of ventricles and atria, which contract in turn to provide blood circulation to the entire body. The heart works under the influence of electrical impulses that are produced by its specific structures.

The sinus node is the dominant impulse-generating structure. After the impulse leaves this node, it is carried out to the atria, which contract because of this. Then it reaches the atrioventricular node. This node is located between the ventricles and atria and is a kind of gateway for the eclectic impulse between these two structures. The impulse is delayed for a fraction of a second in the atrioventricular node. This is necessary so that the blood has time to move from the atria to the ventricles. Then this impulse is carried out along the trunk of the His, reaching the ventricles, thereby forcing them to contract and pour blood into the general channel.

So, in simple terms, left ventricular His bundle block is a conduction disorder in which the electrical impulse stops or slows down.

Blockade of the left ventricle of the heart appears against the background of ischemic or hypertension or a number of other cardiovascular diseases.

Classification

Blockade of impulse conduction can occur anywhere in the leg, and it can be complete or incomplete. And since the left leg is divided into the back and front parts, various classification options arise:

• Complete left ventricular block

Consequences of complete blockade of the left bundle branch

The heart is a unique organ that governs itself, i.e. has automaticity, but, of course, taking into account the needs of the body and not without interfering with the work of the nervous and endocrine systems. This organ is not just a muscle sac, which is a pump for pumping blood; the heart is much more complex than it might seem.

The structure of the heart and the resulting causes of blockades

In addition to the muscles, four cavities, valves, and its own coronary vessels, it has a conduction system and its two centers (pacemaker). From the main center (the pacemaker of the first order), electrical impulses enter the second, and then along the left and right branches of the His bundle they spread to the entire myocardium, which then contracts (and pushes blood out of the heart).

Naturally, if there is a blockade, in this case a complete blockade of the left bundle branch. therefore, the impulse cannot spread further, and this leads to disruption of the rhythm and, in general, the work of the entire heart. The reason for this may be myocardial infarction; it should be assumed first of all if the blockade occurred for the first time. Other causes: cardiosclerosis, cardiac dystrophy, hypertension, cardiomyopathy, myocarditis, etc.

Consequences of the blockade

Complete blockade of the left bundle branch leads to disruption of the conduction of electrical impulses to the left ventricle. But even despite the complete blockade, the impulse still passes, but along bypass routes (anastomoses), and with a delay.

What is the danger of complete blockade of the left bundle branch?

Even a complete bundle branch block may be asymptomatic and may not initially pose a serious threat to life. However, over time, the condition worsens, ventricular arrhythmia develops, more often one of its types is ventricular paroxysmal tachycardia. It is this that ultimately leads to ventricular fibrillation: random contraction of myocardial muscle fibers, which is incompatible with life and inevitably leads to death.

Treatment

There is no specific treatment for blockade. With this pathology, treatment is aimed at eliminating the underlying disease, which caused the blockade. As a rule, cardiac glycosides, nitrates, and blood pressure-lowering drugs are prescribed. If the heart rhythm does not recover, then they resort to surgery: installing a pacemaker.

Rehabilitation for cardiac arrhythmia

In addition to drug therapy for the underlying disease causing the blockade, treatment should include additional non-drug methods related more to rehabilitation measures. In general, this tactic is suitable for other causes of left ventricular block. For example, physical therapy. Physical exercise not only tones the entire body, but has a particularly beneficial effect on the cardiovascular system, increasing the supply of oxygen and generally reducing the mechanical load on the heart. Simply put, by moving, we help the heart accelerate blood. Of course, strength exercises are not suitable here. Choices: Walking or jogging. But in physical therapy it is very important, especially for heart diseases, that the load be dosed and adequate to the capabilities of the heart. Otherwise, you may get a negative effect.

Left ventricular block

The heart muscle has special properties compared to other organs of the human body. One of these properties is the conductivity of impulses that arise in special structures of the cardiac tissue. Sometimes it happens that the impulse is not transmitted by the heart cells. Such conditions are called blockades.

Block of the left ventricle of the heart or, as it is called in medical practice, block of the left bundle branch in most cases is only a complication of the disease. Accordingly, if there is damage to the right bundle branch, blockage of the right ventricle of the heart occurs. Diseases that can lead to blockade occur both in young people (heart defects) and in old age (arterial hypertension, ischemic heart conditions, etc.).

For reference

Recently, left ventricular block has been used as a term that has a broader concept than “left bundle branch block.” This is due to the mechanism of impulse transmission. The fact is that the left bundle branch is divided into two legs: anterior and posterior. Sometimes the block occurs at the site of division into the anterior and posterior branches; in such cases, diagnosis by establishing the level of the lesion is difficult. As a result, they decided to introduce a more extensive concept.

Types of blockades

In addition, blockade of the left ventricle can be complete or incomplete. An incomplete blockade does not pose any danger to life. The symptoms that are observed with it are weakness, slow pulse (bradycardia). If an incomplete blockade is detected on the ECG, the signs of which will be a deviation of the electrical axis of the heart to the left and hypertrophy of the left ventricle, the main thing is to exclude myocardial infarction, which is very often “masked” in the lines of the cardiogram with incomplete blockade of the left ventricle.

Symptoms and ECG

The main tool in diagnosing “blockade...” is an electrocardiogram, which may look different in the same cases, although it was done on the same device.

Things are very serious with complete blockade of the left bundle branch (left ventricular block). First, I would like to tell you what happens normally: the left ventricle is “responsible” for releasing oxygenated blood into the aorta. If the left ventricle fails, the release of oxygenated blood is delayed or stopped, which leads to oxygen starvation of all organs and systems (primarily the brain). Clinically, this is manifested by breathing disorders (shortness of breath), dizziness, drowsiness, a decrease in heart rate to 25 beats/min and, in the end, acute heart failure, which can result in death if timely and correct medical care is not provided.

Diagnosing a complete blockade with an experienced doctor does not pose any particular difficulties. Everything will be visible on the ECG. Provided there is no other pathology.

Dangerous conditions

Complete blockade and myocardial infarction or complete blockade and unstable angina are very common. It is much more difficult to treat complete blockades. To date, there are no specific recommendations on this matter. The main thing is to stop the acute condition, and then prevent recurrences, so to speak, carry out prevention. Also read about the consequences of a complete block of the left bundle branch.

This condition can be cured in different ways, including the use of an electric defibrillator. Then, when the condition has stabilized, drug therapy is carried out, drugs that improve the quality of life (beta blockers, etc.), and antiarrhythmic drugs are prescribed.

Prevention

It is advised to follow a diet (blockades often occur due to obesity). All this is for older people who have, so to speak, “acquired” diseases. For people with defects, the most optimal treatment method is heart surgery to eliminate the defect. Another direction in treatment is the installation of a pacemaker. In modern conditions, the approach to all patients is individual.

The most common causes of this disease are coronary heart disease and hypertension. These diseases can appear together or separately. In 77-80% of LBBB they are the cause.

Among other things, left bundle branch block can be caused by:
- aortic valve disease;
- diseases Lenegre, Lev;
- cardiomyopathy;
- myocarditis;
- hyperkalemia;
- neoplasms of the heart;
- dystrophy of the heart muscle.

Sometimes (extremely rarely) left bundle branch block may also occur in absolutely healthy people, but it cannot be ruled out that in these cases the heart pathology was very minor and unnoticeable.

There is no specific treatment for this disease, and therapy is limited to treating the underlying disease that is the cause of the left bundle branch block.

But we would like to dwell in more detail on one immune drug, which is today perhaps the most effective means for the prevention and treatment of blockade of the left bundle branch. This is Transfer Factor Cardio. The basis of this drug is made up of immune molecules - transfer factors, which, when entering the body, perform the following functions:
- enhance the effect of medications aimed at correcting the functioning of the cardiovascular system and at the same time eliminating all their side effects;
- strengthens human immunity against a variety of causes that cause heart and vascular diseases:
- being the “immune memory” of the body, the immune particles of the drug “remember” all foreign elements that cause various diseases and, when they reappear, identify them and give the command to the immune system to destroy them.
No other drug has such a “mechanism of action” and that is why the immunomodulator TF Cardio today has no analogues in the world in terms of its effectiveness.

Left bundle branch block: prognosis

In this case, the prognosis is worse than with right bundle branch block. Approximately 2% of patients with LBBB develop complete atrioventricular block within 10 years. Left bundle branch block in the setting of acute myocardial infarction increases the possibility of death by 60%.

Average survival with LBBB:
- with a normal heart size - 4.3 years;
- with an enlarged heart - 2.5 years.
Patients, as a rule, die suddenly and the main reasons for this are ventricular fibrillation or ventricular tachycardia.

The prognosis of left bundle branch block is significantly worsened by:
- angina pectoris;
- cardiomegaly;
- heart failure;
- atrial fibrillation;
- myocardial infarction...

Each of us knows how to treat colds, but when it comes to the heart, we panic. Many people, risking their health, self-medicate, which is absolutely forbidden to do for any ailment. The first thing you need to do is consult a doctor to prescribe an examination, and only then, after determining the diagnosis, treatment can be prescribed.

From year to year, more and more people are diagnosed with left bundle branch block. There are several varieties of it, but without proper treatment and prevention, related problems and diseases arise. The development of the pathology is quite rapid, and even if you feel well and do not notice any changes, this is temporary, so if you have been diagnosed with this disease, listen to the recommendations of the cardiologist.

Let's understand what blockade of the left bundle branch is, the probable symptoms, how it is diagnosed and what preventive measures are used.

Left bundle branch block

The bundle of His (PH) is a cluster of cells of the cardiac conduction system about 20 mm long, which is located under the atrioventricular or atrioventricular (AV) node and the interventricular septum, and is divided into the left and right legs.

In turn, the right leg and the left, which are divided into two more branches connected by a network of anastomoses, descend down on both sides of the interventricular septum. The legs are divided in the ventricular myocardium into thin bundles of cardiac conductive myocytes (Purkinje fibers).

Rhythmic impulses can only be generated by special cells of the pacemaker (pacemaker) and the conduction system of the heart. This pacemaker is the sinoatrial or sinoatrial (SA) node, which is located in the wall of the right atrium.

Excitation from the SA node spreads through the atria, and then through the conduction system the impulses are transmitted to the atrioventricular node. The His bundle transmits excitation from the atrioventricular node to the ventricles.

In the conduction system of the heart there is a sinus impulse that is formed during cardiac activity in the node of the same name. In the event that there is a blockade of the left bundle branch in the body, interference is created that forms a kind of obstacle to the normal passage of the impulse.

The most common phenomenon is disturbances along the entire path of the impulse. In this case, violations can be divided into several groups, depending on the location of the problem:

• sinus impulse block;
• atrioventricular block;
• failure of intraventricular conduction.

In addition, the ventricular conduction system is conventionally divided in thematic classification into right and left legs. The right leg is one wide bundle that branches mainly in the thickness of the muscles.

In turn, the left leg is divided by specialists into several more branches: the anterior and, accordingly, the posterior. During normal functioning of the cardiovascular system, the sinus impulse always excites the interventricular septum first.

If there is a blockade of the left bundle branch, both the path and time of excitation of the ventricles radically changes.

It is not possible to diagnose the problem yourself. The only way out is to see a doctor, who will probably oblige the patient to do an ECG. Then, based on the data obtained, the patient will be prescribed high-quality and effective treatment, thanks to which the disease will recede.

Characteristics of the disease

A complete blockade can affect both legs at once, or simply reach their branch, interfering with the conduction of the impulse. As a rule, it travels along the right leg in the usual way, exerting a stimulating effect on both the entire right ventricle and the septum.

The activation wave slows down and spreads to the left ventricle along the contractile fiber. Because of this, the total activation time of both increases.

The consequences of the blockade are quite serious, as they lead to disturbances in the left ventricle, preventing the normal conduction of electrical impulses. It will, of course, pass, but not just with a delay, but also through anastomosis (that is, a bypass route).

The danger of the pathology lies in its practically asymptomatic course, and in the initial stages it is generally considered not to seriously threaten health. The aggravation occurs against the background of the rapid development of arrhythmia in the ventricles. At this stage, paroxysmal ventricular tachycardia is already beginning to appear.

Treatment must be carried out necessarily, since the pathology gradually worsens and ventricular fibrillation develops. Such a diagnosis means that the myocardial fibers begin to contract individually and quickly, which seriously increases the load on the muscle.

Important! Contact your doctor promptly as soon as you notice even the slightest problems in your heart. Many people mistakenly think this is a sign of stress or fatigue, but it is often a signal of much more serious problems!

In many cases, under stress, stress or other negative situations, this can even lead to death. If there is a block of the anterior branch of the left leg, then the passage of the impulse will be disrupted in the area of ​​the anterolateral surface of the left ventricle.

The right ventricle is not involved in the process, since the right bundle branch is responsible for it. According to statistics, this pathology can be diagnosed in 3 out of 4 elderly people, that is, 75%. Conduction disturbances are often the most important sign of cardiovascular diseases.

With blockade of the anterior branch of the left bundle branch, the symptoms are nonspecific or completely absent. In rare cases, arrhythmia is observed. As for the pathology of the posterior branch, the conduction of excitation in the posterior and lower portion of the left ventricle is disrupted.

You can often encounter a condition where there is a blockade of the left and right legs at the same time. This indicates pronounced changes in the heart muscle.

LBBB can be caused by damage at various levels:

• lesion of the left leg in the trunk of the His bundle;
• damage to the main trunk of the left leg before its branching;
• simultaneous damage to the anterior and posterior branches of the left leg after their separation from the main trunk of the left leg;
• damage to the left half of the interventricular septum involving both branches of the left leg;
• the presence of pronounced diffuse changes in the myocardium of the peripheral branches of the anterior and posterior branches of the left leg.

Despite the above options, as a result, with LBBB, excitation cannot pass in the usual way along the left leg to the myocardium of the left ventricle - excitation is carried out in an unusual way, which causes a slowdown in the passage of excitation through the ventricles, as evidenced by the broadening of the QRS complex and a change in the direction of repolarization in the left ventricle:

• in the left precordial leads the QRS complex is represented by a wide tooth RV5, V6 with a notch;
• in the right chest leads, a QRS complex of type rS, QS with a wide and deep tooth SV1, V2 is recorded.

A particularly inquisitive reader who wants to understand in more detail the electrophysical processes occurring during blockade of the heart muscle can do this independently by analogy with the reasoning given on the page “Myocardial excitation”, but it should be borne in mind that with blockade of the left bundle branch:

1. Excitation stage 1:

the left ventricle and the left part of the interventricular septum are not excited; excitation along the right leg is transmitted in the usual way and causes excitation of the right half of the interventricular septum (vector directed to electrode V6);

at the same time, excitation of the right ventricle begins (the vector is directed to the V1 electrode); excitation from the right half of the interventricular septum passes to the left and flows slowly; as a result, the total EMF vector is directed towards electrode V6,

since the total thickness of the interventricular septum significantly exceeds the mass of the right ventricle: the beginning of the RV6 wave and the QV1 or rSV1 wave are recorded (this is due to the fact that at the beginning of the electrical systole the vector of the right ventricle is close to the V1 electrode, which sometimes makes it possible to register a small rV1).

2. Excitation stage 2:

this is the final excitation of the interventricular septum, flowing from right to left: further descent of the SV1 teeth (QSV1) and rise of RV6 are recorded.

3. Excitation stage 3:
is caused by excitation of the left ventricle, which follows an unusual path and proceeds slowly: a further descent of the SV1 teeth (QSV1) and a further rise of RV6 are recorded, while a notch is usually observed on the RV6 tooth,


located on the ascending knee (there are several options for explaining this phenomenon, such as: the presence of a short period of time between stages 2 and 3;

the predominance of the vector of final excitation of the interventricular septum over the vector of initial excitation of the left ventricle; different interaction between the vector of the interventricular septum and the vector of the left ventricle).

Due to the slow spread of excitation, a widening of the QRS complex is noted.

4. The repolarization process begins in the right ventricle and spreads from the epicardium to the endocardium (the vector is directed towards the V1 electrode).

The process of repolarization in the left ventricle is associated with delayed depolarization, and spreads from the endocardium to the epicardium. As a result, the repolarization vector of the left ventricle has the same direction as the right one - to electrode V1 (registration of positive TV1, the ST segment in this lead is located above the isoline;

in lead V6, the TV6 wave is negative and asymmetrical with the greatest negativity at the end of the wave, and the STV6 segment is lowered below the isoline).

The table on the right shows the ECG (12 leads) of two patients: a healthy person and a patient diagnosed with “sinus rhythm with left bundle branch block” (bases: wide QRS complexes - 0.14 s, jagged RV6 wave, inversion of TI, aVL, V6). ECG tape speed is 25 mm/s (1 horizontal cell = 0.04 s).

Anatomical aspects

To understand what blockade of the anterior and posterior branches of the left bundle branch is, you need to know about the conduction system and its main properties.

The main functions of myocardial cells are the ability to excite, conduct nerve impulses and contract. Due to this, normal blood flow and oxygen supply to tissues and organs are ensured. These processes are closely interconnected.

Correct contraction of the heart is ensured by the continuous flow of nerve impulses through various structures. It goes from top to bottom. This is ensured through the conduction system, most of which is represented by the trunk of His.

It is located in the thickness of the interventricular septum. Consists of two legs - left and right. The first has branches into the anterior and posterior. They go to the corresponding walls of the ventricles. The branches of the left bundle branch terminate in the myocardium with Purkinje fibers. These structures carry the path of the nerve impulse.

Blockades of the left bundle branch and its branches are called slowdown or absence of excitation along one or two branches. The consequence is a disrupted sequence of the nerve impulse path. Excitation will first cover the interventricular septum. Then the unchanged right bundle branch (RBB) will reach the ventricle.

This is normal. The blocked ventricle on the left is the last to be excited due to impulses from Purkinje fibers and the undisturbed branch of the His bundle. This is reflected in the electrocardiogram accordingly.

Signs of blockade depend on the form of pathology and concomitant diseases in the patient. Right unilateral blockade often occurs without visible symptoms and is discovered accidentally during a routine ECG.

Sometimes the patient experiences a pain syndrome that spreads to the area of ​​the heart, shoulder blades, collarbones, rapid heart rate, shortness of breath, loss of performance, which is explained by the underlying pathology that provoked the blockade.

When the left bundle (anterior or left branch) is blocked, the patient notices dizziness, periodic heart pain, the pain syndrome is often temporary and intensifies with physical activity.

Patients experience rapid heartbeat and shortness of breath. Symptoms of the pathology include fatigue, loss of performance, and depression. Three-bundle blocks are divided into complete and incomplete.

The first option is accompanied by a complete block of the passage of cardiac impulses. Due to the impossibility of conducting impulses through this section, separation of contractions of the atria and ventricles occurs. The rhythm of contractions is from 20 to 40 beats/min.

The result of this is the risk of blood escaping into the aorta. Symptoms of the pathology are pronounced:

• frequent dizziness;
• fainting;
• interruptions in heart rhythm;
• chronic fatigue, depression;
• chest pain;
• headache.

Sometimes, against the background of severe disturbances, sudden cardiac arrest is diagnosed. Partial blockade is diagnosed in patients whose electrical impulses travel through intact heart fibers. Here the signs are mild, complications are less common.

There are 8 groups of causes of cardiac conduction disturbances.

1. Cardiac (heart) causes:

• coronary heart disease (insufficient blood supply and oxygen starvation) and myocardial infarction (death of a section of the heart muscle from oxygen starvation with its further replacement by scar tissue);
• heart failure (a condition in which the heart does not fully perform its function of pumping blood);
• cardiomyopathies (heart diseases manifested by damage to the heart muscle);
• congenital (arising in utero) and acquired heart defects (serious abnormalities in the structure of the heart);
• myocarditis (inflammation of the heart muscle);
• surgical interventions and heart injuries;
• inflammatory diseases of the heart muscle (myocarditis);
• heart damage due to autoimmune diseases (conditions in which the immune system has a damaging effect on the body’s own tissues);
• arterial hypertension (persistent increase in blood pressure, accompanied by changes in the structure and functioning of the heart due to increased load on it).

Medicinal (medicinal) causes - prolonged or uncontrolled use of certain medications, such as:

• diuretics (medicines that increase the production and excretion of urine).
• antiarrhythmic drugs (drugs that can cause rhythm disturbances).
• cardiac glycosides (drugs that improve heart function by reducing the load on it).

Electrolyte disturbances (changes in the proportions of the ratio of electrolytes (salt elements) in the body - potassium, sodium, magnesium).

Toxic (poisonous) effects:

• smoking,
• alcohol.

Imbalance (impaired functioning) of the autonomic nervous system (the part of the nervous system responsible for the functions of the body necessary to maintain its vital functions).

Hormonal disorders (diseases of the adrenal glands, thyroid gland, diabetes mellitus - damage to the pancreas, in which the hormonal regulation of glucose - blood sugar metabolism occurs).

Chronic hypoxia (insufficient oxygen supply) in various lung diseases (chronic bronchitis, bronchial asthma).

Idiopathic blockades are those that occur for no apparent reason (detectable during examination).

Second degree block resembles right ventricular block. It is usually transient, occurring before the development of a fixed blockade. If conduction in the ventricle is normal, then a negative T wave is relatively common, even in the absence of heart disease.

This explains the frequent persistence of a positive T wave in complexes with left ventricular blockade. Although second-degree left ventricular block is not usually associated with exercise-induced myocardial ischemia, left ventricular block has recently been described in association with myocardial ischemia. This type of block can be proximal or peripheral.

With the proximal type, the impulse slowly moves along the branching of the left bundle (less often along the left bundle branch), but the deceleration is less than 0.06 s. Subsequently, part of the left septum depolarizes abnormally along the transseptal pathway, while the rest of the left ventricle depolarizes normally, albeit with a delay.

The QRS loop shows that the smoothness is not medial and therefore both the loop and the QRS complex, although they have different durations, never exceed 0.12 s. The initial abnormal depolarization leads to the disappearance of the q wave in the left precordial leads and in lead I.

The less the transseptal depolarization is disturbed, the less the repolarization opposes the QRS complex. As a result, the T wave, although it can be negative, is more often negative-positive or even completely positive in the leads related to the left ventricle.

With lesser degrees of left ventricular blockade, the ECG almost always remains normal, because in this case the likelihood of any disturbance of transseptal depolarization is small and the T wave is positive in leads I, aVL, V5 and V6.

It is confirmed only by the disappearance of the first vector, which is compensated by the simultaneously recorded right forces: this is confirmed by the presence of a QS wave in lead V1 and a single R wave in leads V6 and I. In lead V1 there may be an r wave arising in the right part of the septum or the wall of the right ventricle .

The possibility of septal infarction (the T wave is usually negative in leads V1-V2), septal fibrosis, emphysema, and dextrarotation (the latter two often have a 5 wave in lead V6) should also be considered.

It was already mentioned above why - + or a positive T wave can sometimes occur with complete blockade of the left ventricle. If the conduction slowdown in the left ventricle occurs at the level of the peripheral parts and is less than 0.06 s, then this gives a similar ECG picture.

If the midseptum is not depolarizing as slowly, the QRS complex will be slightly wider, but with a q wave in leads I and V6. Intracavitary ECG reveals a prolonged HV interval, a V-ADV of zero, and a widened QRS with mild left ventricular block, but less severe than with complete left ventricular block.

With incomplete blockade of the left leg, excitation may occur, but somewhat slowly. With incomplete RBBB, the QRS complex is shaped like a left bundle branch block, but the QRS width is less than 0.12 s:

• In chest leads V1, V2, the QRS complex has the form rS, QS.
• The STV1,V2 segment can be located on the isoline or above it, the TV1,V2 tooth is usually positive.
• In the chest leads V5, V6, an ECG is recorded that looks like an R wave (qV5, V6 is absent).
• The STV5,V6 segment can be located on the isoline or below it, the TV5,V6 tooth can be of any shape.

ECG for LBBB

The left leg in its structure has anterior and posterior branches that feed on blood from various arterial vessels. As a rule, a violation of the passage of an impulse in this department is not accompanied by a sharp expansion of the QRS complexes, as in the case of damage to the right leg, but it gives a clear picture of the deviation of the electrical cardiac axis in the frontal plane.

Visual signs of complete (affecting both branches) blockade of the left leg on the ECG include:

• There may be a prolongation of the ventricular complex beyond 0.120 seconds.
• The presence of deep long S waves in leads V4-V6.
• The presence of long and deformed R waves in leads I, aVL and V5-V6.
• Absence of Q on graphs I, V5-V6.

The blockade of the anterior branch of the left bundle branch of His looks like this:

• A pronounced deviation of the heart axis to the left side (from -30 to -90 degrees).
• Small R waves combined with deep S waves in II, III and aVF.
• Small Q waves in I and aVL.

Blockade of the posterior branch of the left leg of His looks like:

• A pronounced deviation of the heart axis to the right side (from +120 to +180 degrees).
• Ventricular complex of normal duration.
• Small Q waves in combination with high-amplitude R waves in II, III and aVF.
• Small R waves in I and aVL.

In the ECG conclusion, following the nature of the rhythm, they indicate the location of the electrical axis of the heart, give a description of the blockade of the left leg (complete, incomplete), mention the lengthening of the electrical systole of the ventricles, and give a general description of the ECG.

If there is simultaneously hypertrophy of the right or left ventricle, then its description is usually given before the general characteristics of the ECG. LBBB is observed with pronounced changes in the myocardium of an inflammatory or sclerotic nature:

1. Occurs with left ventricular hypertrophy;
2. Circulatory failure;
3. With cardiosclerosis;
4. Myocardial infarction;
5. For symptomatic renal hypertension;
6. For myocarditis, rheumatism;
7. For aortic heart defects;
8. For heart damage in patients with diphtheria, uremia;
9. For congenital heart defects.

LBBB usually does not occur in healthy people.

Left bundle branch block - diagnosis

Diagnosis of this conduction disorder is based on the results of instrumental studies. Electrocardiography is of greatest importance. Other types of it can also be used: 24-hour monitoring, rhythmocardiography.

In order to determine organic pathology, it is recommended to perform MRI, positron emission tomography, and echocardiography. With pathology of the anterior branch of the left leg, the following changes can be seen on the cardiogram: the appearance of a Q wave in standard lead I and aVL.

The most characteristic sign is a high R wave in these same leads and a deep S wave in lead III and aVR. Prolongation of the QRS complex is often noted. The posterior branch block is characterized by the presence of a Q wave in lead III and an R wave in lead I and aVL. In addition, deep S is observed in leads I, aVL and VI.

A distinctive feature of the blockade of the posterior branch of the left leg is a change in the electrical axis of the heart. It deviates to the right or has a vertical position.

Detection of lesions of the His trunk occurs only when performing an ECG in 12 standard leads. The changes are caused by a disturbed excitation pathway. Each type of blockade has its own distinctive features.

Signs of complete blockade of LBP on the cardiogram are:

1. M-shaped QRS complexes in leads I, aVL, V5, V6.
2. Deviation of the electrical axis of the heart to the right.
3. Increase in the QRS complex by more than 0.12 s.
4. Changes in leads V1, V2, III, aVF.

Blockade of the anterior branch of the left bundle branch on the ECG is accompanied by certain signs:

1. Change in the direction of the electrical axis of the heart (position sharply to the left).
2. There is no expansion of the ventricular complex.

If BZVLNPG occurs, then the following changes are recorded:

1. The electrical axis of the heart is deviated to the right.
2. The QRS complex is of normal size, no deformation is observed.

These signs of blockade are indicated by the doctor when deciphering the cardiogram, which allows for a faster diagnosis. Finally, the width of the complexes, the average value of the heart rate and all detected changes are entered. Ultrasound of the heart with blockade of the left anterior and posterior branches is of secondary importance.

It allows you to determine the underlying disease that caused conduction disorders. Diagnosing myocardial infarction is considered a difficult task when a complete block of the left leg is registered, since it “hides” the cardiographic criteria.

Holter study - 24-hour ECG monitoring shows a constant, periodic type of complete or incomplete blockade. In the second case, you can find out the cause of its occurrence.

During the examination, the patient keeps a diary where he records his daily manipulations. BPVLNPH is often recorded during physical and emotional stress. The Holter study is important for identifying various arrhythmias against the background of changes in conductivity.

Treatment of such a deviation as complete blockade of the NPH involves treatment of the factors and diseases that caused it, because only this becomes the main cause of the development of the problem.

Depending on the type of disease that provoked the complete blockade, different drugs are used, but among them the most often used are nitrates, cardiac glucosides, as well as drugs that lower blood pressure.

They use different methods to restore the heart rhythm, and if none of them help, the doctor may recommend surgery. In this case, a pacemaker is installed, which will regulate the functioning of the heart.

Non-drug methods are always combined with drug therapy, since in this case there is a higher chance of getting a positive reaction to certain techniques. Some techniques are more suitable for the rehabilitation period, but are also widely used during the period when intensive treatment is carried out.

This includes:

• unloading in nutrition (that is, removing heavy foods);
• compliance with the regime;
• load dosing;
• physiotherapy.

In the latter case, classes are initially carried out with an instructor, since the task of the load is to provoke the normal functioning of the venous and vascular system, obtain more oxygen, but at the same time reduce the load on the heart muscle itself.

Attention! Be sure to consult with a specialist so that he can choose the optimal level of training for you. All loads must be not just dosed, but also adequate, suitable for the condition and function of the heart. Otherwise, they have a deeply negative effect.

The pathology of the left leg is only a sign of the underlying disease. There is no specific treatment for this condition. Therapy should be aimed at treating the underlying disease (coronary artery disease, hypertension, myocarditis).

If the blockade is complicated by heart failure, angina pectoris, hypertension, then treatment should include taking cardiac glycosides, nitroglycerin, and antihypertensive drugs.

Recently, a drug such as Transfer Factor Cardio has been successfully used. This is an immune remedy that enhances the effect of other medications, stimulates the immune system, and has the property of immune memory.

It is important that a branch block can lead to complete atrioventricular block, which worsens the prognosis for life. Left leg block can cause sudden cardiac death.

The average survival rate is 2.5 to 5 years. Thus, the pathology of the conduction system of the heart is very dangerous and, if left untreated, can lead to the death of the patient.

Any LBP blockade detected for the first time requires hospitalization in a specialized department. The changes do not require special treatment, but careful diagnosis is necessary.

It is worth noting that the first occurrence of complete LBBB, accompanied by pain in the heart area, is regarded as an emergency pathology.

Such patients are hospitalized in the intensive care unit or intensive care unit. Treatment in these cases is similar to that for acute myocardial infarction!

In other cases, patient management is reduced to treatment of the underlying disease and prevention of its complications. Knowing what LBP blockade is, you can understand that it does not pose a serious health hazard. However, it always requires a thorough examination of the patient to identify cardiac pathology and select rational treatment.

LBBB can have unpredictable and sometimes even very dangerous consequences for the cardiovascular system, which will take a long and painful time to get rid of. It would be much more reasonable to start treatment on time or, if there is a tendency to problems, to take preventive measures.

The main task that the attending physician sets for himself is to find and eradicate the root cause of LBP, which provoked the disorders. If the patient suffers from heart failure or other disorders, most often he has to take glycosides, antiarrhythmic and antihypertensive drugs.

If there is a congenital defect, only surgical intervention can cause improvement. Of course, if the patient's condition is satisfactory, we can limit ourselves to maintenance therapy. However, the doctor can make an appropriate decision only during the examination.

Incomplete block of the anterior branch of the left bundle branch suggests slow motion of the impulse, which can only be identified by ECG. After the diagnosis is made, a treatment regimen is prescribed, which never contains glycosides. It is thanks to them that the blockade has every chance of developing into its full form.

To ensure that unpleasant symptoms do not in any way disturb a person’s peace, patients are strongly advised to reconsider their lifestyle, eliminating bad habits and introducing physical activity.

Such simple rules are relevant for absolutely any disease. If you follow them, signs of health problems will not knock on your door for a long time! Treatment should be carried out only after consultation with a cardiologist.

Treatment consists, first of all, of competent treatment of the underlying disease. If the patient does not have serious abnormalities, we can recommend taking herbs that normalize heart rate and conduction of nerve impulses. These home remedies have been tested for generations and proven to be effective.

1. Ramson (bear onion)

Wild garlic bulbs contain ascorbic acid (a natural analogue of aspirin), allicin, healing mineral salts and essential oils, as well as sugars that normalize the activity of the heart muscle.

As an auxiliary and preventive remedy, herbalists recommend taking an infusion of wild garlic. Recipe: combine a teaspoon of chopped wild garlic bulbs with 300 ml of cold water.


Leave for one hour, then strain and refrigerate. Take 30 ml of the resulting drink three times a day. Attention! Treatment with wild garlic is contraindicated for gastritis and stomach ulcers!

2. Jaundice spreading

Spreading jaundice is another plant unique to the heart. It contains cardiac glycosides - erizimoside and erizimin, as well as organic acids and fatty oils.

The main indication for the use of jaundice is mitral valve defects (and it is precisely this disease that is often associated with blockade of the right and left bundle branches). In general, the plant normalizes blood circulation, increases the conductivity of electrical impulses, protects against heart attack and stroke, and improves the patient’s overall well-being.

You can use a water or alcohol tincture of common jaundice. To prepare a water tincture, you will need a teaspoon of herbs per 200 ml of boiling water. Dosage – a teaspoon three times a day (for atrial fibrillation, the dosage can be increased to 1 tablespoon 3 times a day).


To prepare an alcohol tincture, you will need 20g of spreading jaundice herb and 100 ml of alcohol. The mixture is infused in a dark place for 2 weeks, after which it must be filtered. Dosage – 10 drops 3 times a day before meals (you can wash the drops down with water). Continue treatment for 6-10 months to obtain a stable, long-term effect.

3. Common hazel

Hazel will calm the nervous system, enhance the effectiveness of treatment of heart diseases, and prevent serious pathologies in the ventricles. We recommend making tea from this plant.

To do this, you will need a tablespoon of hazel bark or leaves (dry crushed) and a glass of boiling water. Leave the mixture for 20 minutes, then take 100 ml twice a day.

4. Caustic sedum

In folk medicine, treatment with preparations from the herb sedum is popular. This plant contains alkaloids, mineral salts, tannins and organic acids, which tone the body in general, and the heart in particular.

For bundle branch block, this is exactly what we need. Recipe: chop the dry plant, brew a teaspoon of sedum in a glass of boiling water. This is your daily dose. Drink it in a day. Therapy should last from 3 months to a year.

5. Marsh dry grass

Dry grass is another highly effective herbal raw material for preparing a potion for problems with the His bundle.

All people suffering from heart disease (especially older people) can undergo periodic treatment with this herb.


It contains vitamin B1, phytosterols, ascorbic acid, and the alkaloid gnafalin, due to which it has a vasodilating effect, normalizes the balance of nerve impulses and the tone of the smooth muscles of the heart muscle.

Recipe: Brew a teaspoon of dry herb cudweed in a glass of boiling water and leave for half an hour. Take 3-4 tablespoons of infusion 4 times a day 20 minutes before meals. People with heart problems are also recommended to take wine made from cucumber.

To do this, pour a handful of dry herbs with a liter of high-quality red wine, leave for 2 weeks, then strain and add 100 ml of liquid linden honey. Drink 50 ml of the resulting wine every evening before bed.

6. Herbal infusions

Herbal mixtures are more effective because they simultaneously act “on all fronts”: they restore normal functioning of the bundle branch, reduce heart failure, and prevent complications.

• Raspberry fruits – 20g;
• Birch leaves – 10g;
• Leonurus cordial herb – 10g;
• Herb or dill seeds – 10g;
• Periwinkle leaves – 20g.

Brew a tablespoon of this mixture with 0.5 liters of boiling water in a thermos, close the lid and leave for at least an hour. Every time 15 minutes before meals, drink half a glass of this drink. The course of treatment is from one month to a year (depending on the patient’s condition).

In an ancient French herbal medicine reference book we found the following recipe:

• Sage herb – 50g;
• Dill seeds – 50g;
• Medicinal cap herb – 50g;
• White mistletoe – 30g;
• Fragrant rue herb – 10g;
• St. John's wort herb – 10g.

Combine all ingredients. Take a liter of water for 2 tablespoons of the mixture, bring the mixture to a boil, and immediately remove from the heat. Let the drug brew for half an hour, then strain it and drink a glass 4 times a day. In severe cases of heart failure, the dosage is halved.

The following collection provides an excellent therapeutic effect:

• Blood red hawthorn flowers – 30g;
• Small periwinkle leaves – 30g;
• Melissa leaves – 10g;
• Spring adonis herb – 10g;
• Lavender flowers - 10g.

Take a heaping tablespoon of this mixture, pour a glass of cold water and leave for half an hour. Then put the medicine on the fire, boil for 5 minutes and cool. Drink the resulting medicine in small portions throughout the day. The course of treatment must last at least 2 months for you to feel a stable effect.

Forecasting

The prognosis for patients who did not experience any symptoms throughout the entire period during which treatment was carried out is considered quite favorable. If there was any disease that accompanied the complete blockade or caused its development, then the doctor should take into account these factors when making a prognosis.

However, it should also be taken into account that complete blockade of the PNH itself significantly increases the risk of not only the development of very serious complications in the future, but also sudden death.

If the defect gradually progresses, or hypertension, AB blockade, heart failure or cardiomegaly develops, the unfavorable prognosis will be significant.

In patients with partial blockade, the course of the pathology is favorable, especially in those who do not have symptoms or other cardiac pathologies. Patients should take into account that the prognosis depends on the underlying pathology of the heart or blood vessels, as well as on how attentive they are to their health.

The prognosis is unfavorable with complete left hemiblock and three-fascicular block. The first, in the acute period of a heart attack, ends in death in 40–50% of cases, the second is dangerous by the development of asystole, ventricular fibrillation, and sudden death from cardiac arrest.