Retrograde conduction of LBB activation
Previous studies have shown that there was the retrograde activation of
the His bundle in the human heart 22-24, which was
also confirmed by the retrograde His potential recorded in the process
of determination of SLBBP 4. Zhang et al. had
suggested that without RBBB or proximal LBBB, besides the stimulus
conducts rapidly through the LBB and Purkinje fibers to activates LV, it
reversely conducts to His bundle and then conducts forward through the
RBB and Purkinje fibers to activates the RV 25.
However, the process by which retrograde conduction of LBB activation
overcomes structural barriers of longitudinal dissociation within His
bundle to activate RBB is obscure and may be successful through AVN or
TF/FTI. (Figure3 D&E) Even if it can, it is unknown whether it can
recruit the distal RBBB or not.