gms | German Medical Science

33rd International Congress on Electrocardiology

International Society of Electrocardiology

Post - operative Right Bundle Branch block: is there a relationship between QRS prolongation and the T wave-descending limb?

Meeting Abstract

  • corresponding author presenting/speaker A. Benatar - Academic Hospital VUB, Brussels, Belgien
  • H. De Wilde - Academic Hospital VUB, Brussels, Belgien
  • A. Feenstra - Academic Hospital VUB, Brussels, Belgien
  • T. Decraene - Academic Hospital VUB, Brussels, Belgien

33rd International Congress on Electrocardiology. Cologne, 28.06.-01.07.2006. Düsseldorf, Köln: German Medical Science; 2007. Doc06ice122

The electronic version of this article is the complete one and can be found online at:

Published: February 8, 2007

© 2007 Benatar et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Aim: The degree of QRS prolongation in right bundle branch block (RBBB) relates to RV dilatation and potential for arrhythmia. The interval from peak to the end of the T wave (TpTe) reflects heterogeneity of action potential durations in ventricular myocardium and serves as an arrhythmogenic index. We studied the behavior of TpTe and the correlation with QRS duration in patients with post-operative RBBB.

Methods: We enrolled 25 post-operative pts with RBBB (18 post Tetralogy repair, 5 post VSD repair and 2 post AVSD repair) and 97 controls. A 12 lead ECG was digitally recorded. Intervals measured (mean of 5), included QRS duration, QT, JT and TpTe in lead II and V5. TpTe/JT in lead II and V5 was calculated to correct for heart rate. Descriptive and analytical statistics were calculated, significance set at p= < 0, 05.

Results: Mean age, controls 3.9 years (day 2 – 15.85 years) for patients 5.2 years (1 month – 18 years). Mean TpTe in both lead II and V5 for controls was 66 + 11 msec vs. 88 + 13 and 90.5 + 10 msec respectively in RBBB patients (p< 0.05). TpTe and QRS correlated in RBBB patients, r =0.63 (p < 0.001). Mean TpTe/JT II controls was 0.28 + 0.05 and 0.28 + 0.05 for TpTe/JT V5 compared to mean TpTe/JT II 0.39 + 0.09 and TpTe/JT V5 0.40 + 0.08 in RBBB patients (p< 0.05). No RBBB pts had documented arrhythmia. Longest QRS observed was 156 ms and concomitant longest TpTe 120 ms. Heart rate and age correlated poorly with QRS duration and TpTe.

Conclusions: The TpTe interval is considered an approximate surrogate of the intraventricular repolarisation gradient. RBBB pts have longer TpTe than controls as well as longer TpTe/JT. TpTe prolongation correlates with QRS duration in RBBB pts and may serve as index for potential for ventricular arrhythmia in RBBB pts.