Why the study?
What is the correlation between electrophysiologic and pathologic findings in patients with atrioventricular block?
What is the correlation between electrophysiologic and pathologic findings in patients with atrioventricular block?
Electrophysiologic findings such as prolonged A-H interval and H-V prolongation closely correlate with specific pathologic lesions in the conduction system in most cases of AV block.
May aid lesion localization via EP study in AV block; hypothesis-generating from small series, needs validation.
1) A prolonged A-H interval suggested A-V nodal involvement. 2) A prolonged duration of the His potential suggested moderate His bundle involvement. 3) Complete block distal to H appeared to reflect total disruption of both bundle branches. 4) The lesion at the penetrating portion of the His bundle could be responsible for A-H block. 5) A-H block occurred in a case of cellular infiltration in the A-V node and the His bundle, in which bilateral bundle branch showed severe fibrosis. 6) A combination of right bundle branch block, marked left axis deviation and H-V prolongation suggested trifascicular disease. 7) In case 6, there was a severe pathologic lesion at the origin of the left bundle branch, yet left bundle branch block was not indicated electrocardiographically. This study revealed a close correlation between electrophysiologic and pathologic findings in 4 out of 6 cases.
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Ohmae et al. (1980) studied this question.
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