Diagnosis of Ventricular Aneurysm and Other Severe Segmental Left Ventricular Dysfunction Consequent to a Myocardial Infarction in the Presence of Right Bundle Branch Block: ECG Correlates of a Positive Diagnosis Made via Echocardiography and/or Contrast Ventriculography

Background: A diagnostic ECG sign of a ventricular aneurysm (VA) consequent to a myocardial infarction (MI) in the presence of complete left bundle branch block was recently described, and consists of the presence of ST‐segment elevation (+ST), instead of the expected ST‐segment depression (−ST), in leads V4–6. Generally, complete right bundle branch block (RBBB) is associated with −ST in ECG leads V1–3. We hypothesized that stable +ST, instead of the expected −ST in leads V1–3 in patients with RBBB could be also diagnostic of a VA and other severe segmental left ventricular dysfunction (VA/SSD). Thus, this study was performed to explore the feasibility of using the ECG to diagnose a VA/SSD in the presence of RBBB, and to evaluate the determinants of such diagnosis.