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March 1, 1970Circulation

Analysis of the A-V Conduction Defect in Complete Heart Block Utilizing His Bundle Electrograms

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Why the study?

Does His bundle electrogram recording localize the site of block in patients with complete heart block?

Population

21 patients with complete heart block (CHB)

Design

Case_series

Authors

ONOnkar S. NarulaUniversity of MiamiBSBenjamin J. ScherlagElectrophysiologyRJRoger P. JavierMount Sinai Medical Center

Discussion

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Implication

His bundle recordings may localize block in complete heart block; leaves open effects on modern management.

Key Points

  • To investigate the localization of block in complete heart block using His bundle electrograms and assess conduction time.
  • Recorded His bundle electrograms in 21 patients with complete heart block.
  • Measured A-H time and H-V time in relation to block localization areas.
  • Performed atrial pacing to assess conduction behavior.
  • 18 patients had distal block with wide QRS complexes, indicating possible bilateral bundle-branch block.
  • 3 patients with proximal block had normal A-H and H-V times.
  • Demonstrated that ECG criteria for localization of block are unreliable in cases of CHB.

Structured PICO

Does His bundle electrogram recording localize the site of block in patients with complete heart block?

P
Population
21 patients with complete heart block (CHB)
I
Intervention
His bundle (BH) electrogram recording and atrial pacing
O
Outcome
Localization of the site of block (proximal or distal to His bundle) and conduction times (A-H and H-V times)surrogate

His bundle electrograms demonstrate that the majority of complete heart block cases occur distal to the His bundle, likely due to bilateral bundle-branch block.

Cite This Study

Narula et al. (1970) studied this question.

synapsesocial.com/papers/6a1c07d9fc87fd06169d00a5https://doi.org/10.1161/01.cir.41.3.437
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Pervenous Pacing of the Specialized Conducting System in Man1970 · 148 citations
  2. 2VENTRICULAR COMPLEXES IN HEART BLOCK1948 · 29 citations
  3. 3VARIABLE VENTRICULAR COMPLEXES IN HEART BLOCK, AND THEIR RELATION TO BILATERAL BUNDLE BRANCH BLOCK1941 · 11 citations
  4. 4COMPLETE HEART BLOCK1944 · 115 citations
  5. 5Functional Properties of the Atrioventricular Conduction System1963 · 139 citations