ssrpk
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well its true that the shape of QRS complex will depend upon the site of escape rhythm which in case of nodal, will result in narrow QRS while in case of ventricular escape rhythm, it will be broad, and once third degree or complete heart block is documented its further classification into RBBB and LBBB is not relevant clinically because both of them will be treated in a similar fashion.
don't mix up the LBBB and RBBB with the respective axis deviation because in several instances RBBB can be present with normal axis which has no significance.
LBBB cannot be right answer here, because first of all ventricular pacemaker causes ventricular beats which is originated in the right ventricle and travels to the left and thus will surely have a left axis but LBBB won't be it because it has typical ECG appearnces [notched R-waves or double R waves which will take this form only with a rhythm that travels through normal purkinje system proximal to block] thus in the case of ventricular pacing because of origin of ventricular beats QRS complex will be wide.
Edited by ssrpk on 06/02/07 - 08:06 AM
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