Key result
Bi- or trifascicular conduction disease was associated with more electrophysiologic abnormalities of the sinus node or atrium compared to narrow QRS controls (69.2% vs 7.7%; p<0.01).
Why the study?
Do patients with bi- or trifascicular conduction disease have more electrophysiologic abnormalities of the sinus node and atrium compared to patients with narrow QRS?
Observational (n=26)
Do patients with bi- or trifascicular conduction disease have more electrophysiologic abnormalities of the sinus node and atrium compared to patients with narrow QRS?
Patients with bi- or trifascicular conduction disease frequently exhibit concurrent electrophysiologic abnormalities of the sinus node and atrium.
Answers are grounded in this paper and cite their sources.
Supports broader EP evaluation in bi/trifascicular block; leaves open prognostic impact and need for prospective confirmation.
Detailed electrophysiologic evaluation of the sinus node and atrium was undertaken in 26 patients. Half had bior trifascicular conduction disease (BTD) and the others had a narrow QRS (non-BTD). BTD and non-BTD groups were comparable with respect to age, sex and incidence of coronary artery disease (CAD). One or more electrophysiologic abnormalities of the sinus node or atrium were found in nine of 13 BTD patients (more than one abnormality was present in five) and a single isolated abnormality was seen in one of 13 non-BTD patients (p < 0.01). PA interval (41 3 vs 28 3 msec), sinus node recovery time (1289 76 vs 988 44 msec), corrected sinus node recovery time (369 62 vs 221 35 msec), atrial effec- tive (253 14 vs 205 11 msec) and functional (324 15 vs 272 9 msec) refractory periods were significantly longer in BTD than in non-BTD patients (p < 0.05). These differences were greatest when CAD patients were excluded and primary BTD patients (BTD without other evident cardiovascular disease) were compared with controls (narrow QRS without CAD). Sinoatrial conduction time was significantly longer in primary BTD patients (126 11 msec) than it was in controls (82 8 msec).
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Wyse et al. (1979) conducted an observational in Bi- or trifascicular conduction disease (bundle branch block) (n=26). Bi- or trifascicular conduction disease (BTD) vs. Narrow QRS (non-BTD) was evaluated on One or more electrophysiologic abnormalities of the sinus node or atrium (p=<0.01). Bi- or trifascicular conduction disease was associated with more electrophysiologic abnormalities of the sinus node or atrium compared to narrow QRS controls (69.2% vs 7.7%; p<0.01).
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