Affiliation:
1. From the Services of Cardiology of Salaberry Hospital and Argerich Hospital, Buenos Aires, Argentina.
Abstract
Two cases of intermittent bundle-branch block in which Wenckebach periods could be
directly
visualized are reported. The conduction ratios were either 3:2 or 4:3, as are commonly seen in cases of the Wenckebach phenomenon of atrioventricular (A-V) conduction. Other groups of beats apparently showing 3:1 and 4:1 bundle-branch block were interpreted as indicating
incompletely concealed
Wenckebach periods in the bundle branches, with actual conduction ratios of 3:2 and 4:3, respectively.
Three prerequisites are necessary for the occurrence of either direct or incompletely concealed Wenckebach periods in the bundle branches: (1) The opening beat should be normally conducted (in the affected bundle branch); (2) the second beat should be conducted with a delay of no more than 0.04 to 0.06 sec; (3) the damaged bundle branch should not be activated retrogradely in the closure beat.
Wenckebach periods in the bundle branches may be
completely concealed
if the conduction delay lasts more than 0.04 to 0.06 sec in the opening beat. In cases of bilateral bundle-branch block, Wenckebach periods in the bundle branches may be
indirectly visualized
through changes in the A-V conduction.
Publisher
Ovid Technologies (Wolters Kluwer Health)
Subject
Physiology (medical),Cardiology and Cardiovascular Medicine
Reference27 articles.
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