Dissimilar electrocardiographic patterns associated with right bundle branch block have been described. The morphological diversity in right bundle branch block patterns is likely to be related to multiple factors-site of block, nature of defect (functional, necrosis, fibrosis), degree of conduction delay, and associated pathologies with their own ECG patterns. The prognosis of right bundle branch block in the absence of underlying cardiac disease is good but it may be poor in other cases, particularly coronary artery disease. Changing bundle branch block has been described and new right bundle branch block has been described too. We present a case of Pre-bundle branches, right bundle branch conduction disturbances, paroxysmal atrial fibrillation without acute myocardial infarction in a patient admitted for an intestinal subocclusion.
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