His Bundle Recordings in Patients with Bundle Branch Block and Transient Neurologic Symptoms

Author:

SCHEINMAN MELVIN1,WEISS ALAN1,KUNKEL FREDERICK1

Affiliation:

1. From the Cardiopulmonary Laboratory and Medical Service, San Francisco General Hospital, and the Department of Medicine, University of California, San Francisco.

Abstract

His bundle electrograms were recorded in 19 patients with bundle branch block (BBB) and transient neurologic symptoms allowing for determination of intra-atrial (P-A), atrioventricular (A-V), nodal (A-H) as well as infranodal conduction (H-Q) times. The patients were initially monitored in a coronary care unit and have been followed for a mean period of 8 ± 4 months. In six patients (Group I) neurologic symptoms were observed in the absence of electrocardiographic evidence of A-V block. In six patients (Group II) the cause of symptoms was uncertain; two of these patients had relief of symptoms after permanent cardiac pacemaker insertion and were presumed to have episodic high grade A-V block. In seven subjects (Group III) complete A-V block was documented as the cause of the symptoms; these patients were studied when 1:1 antegrade A-V conduction returned. There was no significant difference between mean P-A, A-H, and QRS durations among the patients in the three groups. Mean H-Q (89 ± 20 msec) for Group III was significantly longer than that for Group I (56 ± 9 msec) or Group 11 (64 ± 11 msec) ( P < .001). All patients with presumed or documented episodes of high grade A-V block had abnormal H-Q intervals, and six of the nine patients with presumed or documented complete A-V block had H-Q intervals >80 msec. The present data suggest that patients with transient neurologic symptoms, bifascicular or left BBB associated with marked prolongation of H-Q (≧80 msec), should be seriously considered as candidates for insertion of a permanent cardiac pacemaker even in the absence of documented high grade or completeA-V block.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Cited by 64 articles. 订阅此论文施引文献 订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3