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Right Bundle Branch Block by Diaphragmatic Inspiration Independent of Heart Rate

Arch Intern Med. 1964;114(4):538-540. doi:10.1001/archinte.1964.03860100120015.
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Intermittent bundle branch block was first described by Lewis in 1913.1 Vagal influence on the ventricular complex was first reported by Wilson.2 Many investigators have studied the critical heart rate in relation to intermittent bundle branch block.3-6 Intermittent right bundle branch block related to the heart rate without apparent heart disease was well studied by Lamb and his associates.7-8 Intermittent right bundle block without relationship to the heart rate in an apparently healthy nurse was first described by Sandberg et al.9 However, intermittent right bundle branch block related to the diaphragmatic respiration and not related to the heart rate in a patient without apparent heart disease has never been reported to our knowledge. This special problem will be of interest to both internists and cardiologists.

Report of Case  A 34-year-old Caucasian male was admitted to Kaiser Foundation Hospital on Nov 11, 1959, for cardiac evaluation.


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