Why the study?
Does His bundle electrogram recording reveal prolonged intraventricular conduction time in patients with left bundle-branch block and left axis deviation compared to those with normal QRS axis?
Does His bundle electrogram recording reveal prolonged intraventricular conduction time in patients with left bundle-branch block and left axis deviation compared to those with normal QRS axis?
His bundle electrograms can identify impaired right bundle-branch conduction in patients with LBBB and left axis deviation, potentially indicating the need for a pacemaker in those with syncope.
May identify high-risk conduction delay in LBBB with axis deviation; leaves open whether His recordings guide pacing decisions.
His bundle electrograms have been recorded in 5 patients with left bundle-branch block and additional left anterior hemiblock and in 4 patients with left bundle-branch block and a normal QRS axis. The finding of a prolonged intraventricular conduction time in the patients with left bundle-branch block and left anterior hemiblock indicates delayed conduction down the right bundle-branch, and therefore more widespread disease of the conduction system than is apparent from the external electrocardiogram. The intraventricular conduction time was normal in the 4 patients with left bundle-branch block and a normal QRS axis. It is suggested that the recording of His bundle electrograms in patients with left bundle-branch block and left axis deviation is a useful technique for assessing conduction down the right bundle-branch and if this is found to be impaired, especially in patients with a history of syncopal episodes, this could constitute an indi- cation for the implantation of a pacemaker.
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Spurrell et al. (1972) studied this question.
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