Posts Tagged ‘mechanism of small r in lead v1 v2 v3 in lbbb’

Can there be a small r wave in V1 and V2 in LBBB ?

Yes .

Though we expect the  reversal of septal depolarization that will   extinguish  the initial r in v1 to v3 . It is  preserved in  many. Hence the  presence of small r in v1 to   v3 does not rule out LBBB.

  1. The commonest explanation given is un-masking of RV free wall forces which is   normally  masked by early LV forces .
  2. Another possibility is the   orientation of septum  in pathological states.
  3. Third possibility is  “r” may  actually represent  the  septal q waves as in LVH or old AWMI  .(Counterpart of small  q in lateral leads )

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