USE OF HIS BUNDLE RECORDINGS IN ANALYSIS OF UNILATERAL AND BILATERAL BUNDLE BRANCH BLOCK
USE OF HIS BUNDLE RECORDINGS IN ANALYSIS OF UNILATERAL AND BILATERAL BUNDLE BRANCH BLOCK
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DOI：
10.1016/0002-8703(71)90104-9
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发表时间：
1971-01-01
影响因子：
4.8
通讯作者：
DAMATO, AN
中科院分区：
文献类型：
--
作者：
BERKOWITZ, WD;LAU, SH;DAMATO, AN
他记录了 26 名束支传导阻滞患者的束电图。从希氏束电图到心室激动开始（H-V）的间隔被用作右束支传导阻滞患者左束支传导时间和左束支传导阻滞患者右束支传导时间的近似值。右束支传导阻滞患者的 H-V 间期在“正常”心室激动患者的 H-V 间期范围内。左束支传导阻滞患者的平均 H-V 间期为 22 毫秒。比右束支传导阻滞患者的时间长，并且个体值没有重叠。两名患有交替性 LBBB 的患者在“正常”心室激动期间具有较短的 H-V 值。过早心房刺激导致束支传导阻滞模式正常化，导致 H-V 间期缩短。六名患有右束支传导阻滞和左轴偏差的患者中，有两名患者的 H-V 间期延长，表明左束支最近端部分或后下部分有疾病。在两名 P-R 间期延长且左束支传导阻滞的患者中观察到最长的 H-V 值，表明右束支传导延迟。心房起搏引起的 I 型二度 A-V 传导阻滞导致 H 电位附近的脉冲传输受阻。在 II 型二度 A-V 传导阻滞中，心脏冲动在 H 电位远端被阻断，推测是在对侧束支中。观察到右束支远端部分脉冲传输受阻的隐匿传导。
His bundle electrograms were recorded in 26 patients with bundle branch block. The interval from the His bundle electrogram to the onset of ventricular activation (H-V) was used as an approximation of conduction time in the left bundle branch in patients with right bundle branch block and of conduction time in the right bundle branch in patients with left bundle branch block. The H-V intervals of patients with right bundle branch block were within the range of those noted in patients with “normal” ventricular activation. The average H-V interval of patients with left bundle branch block was 22 msec. longer than that of patients with right bundle branch block and there was no overlap of individual values. Two patients with alternating LBBB had shorter H-V values during “normal” ventricular activation. Normalization of a bundle branch block pattern by premature atrial stimulation resulted in a shortening of the H-V interval. Two of six patients with right bundle branch block and left axis deviation had prolonged H-V intervals suggesting disease of either the most proximal portion of the left bundle branch or of the posterior-inferior division. The longest H-V values were observed in two patients with prolonged P-R intervals and left bundle branch block suggesting delayed conduction in the right bundle branch. Type I second degree A-V block induced by atrial pacing resulted in blocked impulse transmission proximal to the H potential. In Type II second degree A-V block the cardiac impulse was blocked distal to the H potential presumably in the contralateral bundle branch. Concealed conduction with blocked impulse transmission in the distal portion of the right bundle branch was observed.