Concealed intraventricular conduction in the His bundle electrogram.

Author:

Cohen H C,D'Cruz I,Pick A

Abstract

Multiple areas of concealed intraventricular conduction are deduced on the basis of aftereffects observed in His bundle recordings. Electrocardiograms and His bundle recordings are presented from two patients with unstable bilateral bundle branch block, the instability of which depended on the interval at which ventricular depolarization was initiated by sinus or paced impulses. This circumstance allows postulation of 1) concealed transseptal retrograde penetration of the left bundle branch system; 2) concealed transseptal retrograde penetration of the right bundle branch system; 3) alternate beat Wenckebach phenomenon with two areas of block in the bundle branch system with concealed penetration of the proximal area; 4) concealed re-entry in the right bundle branch system during an H-V Wenckebach cycle with resetting of the sequence of 2:1 H-V block and return of the re-entry wave to the A-V node causing subsequent A-H block; 5) proximal 2:1 block and distal Wenckebach block producing only two consecutively blocked beats; and 6) infrahisian Wenckebach block with changes both in A-V conduction and QRS contour.

Publisher

Ovid Technologies (Wolters Kluwer Health)

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine

Cited by 19 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

1. Wenckebach's periods or alternating Wenckebach's periods during 4:1 atrioventricular block?;Journal of Electrocardiology;2005-04

2. Ventricular Preexcitation Syndromes: The Wolff-Parkinson-White Syndrome and Variants;Fundamental Approaches to the Management of Cardiac Arrhythmias;2000

3. Mechanism of Wenckebach periods: hypothesis based on computer modeling experiments;American Journal of Physiology-Heart and Circulatory Physiology;1989-10-01

4. Electrophysiologic Characteristics of Accessory Connections: An Overview;Cardiac Preexcitation Syndromes;1986

5. Electrophysiologic demonstration of concealed conduction in anomalous atrioventricular bypass tracts;Journal of the American College of Cardiology;1985-04

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