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Conduction Disturbances Located within the His Bundle

 

作者: Reinier Schuilenburg,   Dirk Durrer,  

 

期刊: Circulation  (OVID Available online 1972)
卷期: Volume 45, issue 3  

页码: 612-628

 

ISSN:0009-7322

 

年代: 1972

 

出版商: OVID

 

关键词: A-V conduction;Bundle-branch block;A-V block;Mobitz type II A-V block;A-V Wenckebach phenomenon;His bundle recordings;Stimulation studies

 

数据来源: OVID

 

摘要:

Four patients are described with different degrees of conduction disturbance within the His bundle. In one patient with a Mobitz type II atrioventricular (A-V) block with normal QRS complexes the blocked atrial beats were followed by a His potential. Since the QRS complexes of the conducted beats were completely normal, the site of the block was thought to be in the distal part of the His bundle. In the other three patients with a 2:1 A-V block, a nearly complete A-V block, and a complete A-V block, two distinct His potentials could be discerned, one (H) following each atrial beat, the other (H′) preceding each ventricular activation. In the patient with 2:1 A-V block a Wenckebach phenomenon within the His bundle could be produced at certain atrial driving rates. Impulse conduction through the A-V node was normal in all four cases, as could be concluded from the effect of increased atrial driving rate and of accurately timed atrial premature beats. The site of the block could not be predicted from the conventional electrocardiogram.

 

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