PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 679756

Fascicular block within the His bundle.

J A Sobrino·J F Sotillo·A del Rio·N Sobrino·I Maté
View original source ↗Export metadata ↓

Abstract

The findings in a patient with complete atrioventricular block and normal morphology and duration of the QRS complex are presented. A His bundle electrogram was obtained, which led to the location of the atrioventricular block within the His bundle. A careful review of the electrocardiograms obtained during the seven years preceding the onset of complete atrioventricular block showed a QRS complex with the features of left anterior hemiblock and a progressive impairment of atrioventricular conduction. From these data, we inferred that the different degrees of atrioventricular block and the left anterior hemiblock were caused by lesions within the His bundle involving the fibers destined for the left anterior division of the left branch. After the onset of complete atrioventricular block, with the subsidiary pacemaker located in the His bundle distal to the lesions, the QRS complex became normal, indicating the integrity of the bundle branches and fasciculi. The atrial and proximal His potential intervals and those between distal His and ventricular potentials were normal.

Explore related subjects

Bundle of HisElectrocardiographyFemaleHeart BlockHeart Conduction SystemHumansMiddle AgedCase ReportsJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

J A Sobrino, J F Sotillo, A del Rio, N Sobrino, I Maté. 1978. Fascicular block within the His bundle.. https://doi.org/10.1378/chest.74.2.215

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed1995

Ventricular tachycardias with left bundle branch block morphology.

The differential diagnosis of VTs with LBBB morphology includes several well-defined syndromes. Although the majority of cases are attributable to acquired structural heart disease, including ischemia, prior infarction, or dilated cardiomyopathy, consideration of specific right ventricular processes is essential to proper evaluation and treatment. The approach to older patients or those with evidence for heart disease should begin with an evaluation for coronary artery disease and an assessment of biventricular function. Careful evaluation for bundle branch reentry should be performed during electrophysiological study, especially when there is underlying conduction system disease. Younger patients, those without overt heart disease, or those with isolated right ventricular disease, should receive a complete noninvasive evaluation of right and left ventricular size and function. An abnormal SAECG or identification of intracardiac late potentials suggest right ventricular dysplasia or cardiomyopathy, whereas responsiveness to adenosine and absence of detectable heart disease support the diagnosis of idiopathic right VT. Newer techniques, including MRI, show promise in identifying subtle right ventricular disease not otherwise detectable even in the setting of presumed idiopathic right VT. Following surgical repair of selected congenital heart defects, particularly tetralogy of Fallot, symptoms of recurrent palpitations, near syncope, syncope, or aborted sudden death may be attributable to recurrent VT, and diagnostic electrophysiological study should be considered for these patients. Finally, SVTs with LBBB morphology, particularly cases associated with right-sided or septal accessory pathways, should always be considered in this differential diagnosis.

Bundle of His↗