The His Bundle Electrogram in Impaired Atrioventricular Conduction

2015 ◽  
pp. 279-289
Author(s):  
David Hunt ◽  
J. T. Lie ◽  
Jitu Vohra ◽  
Graeme Sloman
2021 ◽  
Vol 10 (3) ◽  
pp. 181-189
Author(s):  
José-Ángel Cabrera ◽  
Robert H Anderson ◽  
Andreu Porta-Sánchez ◽  
Yolanda Macías ◽  
Óscar Cano ◽  
...  

Extensive knowledge of the anatomy of the atrioventricular conduction axis, and its branches, is key to the success of permanent physiological pacing, either by capturing the His bundle, the left bundle branch or the adjacent septal regions. The inter-individual variability of the axis plays an important role in underscoring the technical difficulties known to exist in achieving a stable position of the stimulating leads. In this review, the key anatomical features of the location of the axis relative to the triangle of Koch, the aortic root, the inferior pyramidal space and the inferoseptal recess are summarised. In keeping with the increasing number of implants aimed at targeting the environs of the left bundle branch, an extensive review of the known variability in the pattern of ramification of the left bundle branch from the axis is included. This permits the authors to summarise in a pragmatic fashion the most relevant aspects to be taken into account when seeking to successfully deploy a permanent pacing lead.


1998 ◽  
Vol 8 (4) ◽  
pp. 472-478 ◽  
Author(s):  
Fause Attie ◽  
Pedro Iturralde ◽  
Carlos Zabal ◽  
Maria Rijlaarsdam ◽  
Alfonso Buendia ◽  
...  

AbstractWe describe 4 cases of congenitally corrected transposition associated with atrioventricular septal defect, diagnosed by echocardiography and angiocardiography. Two had usual atrial arrangement and two had mirror imaged atrial arrangement. All cases were associated with subpulmonary valvar stenosis. All patients presented with cyanosis and were in sinus rhythm. Atrioventricular septal defect with common atrioventricular junction was easily diagnosed on the basis of a common atrioventricular valve permitting interatrial and interventricular communications. All patients had balanced right and left ventricles. The echocardiographic recognition of the ventricles was based on the presence of the moderator band within the morphologically right ventricle, the characteristics of the apical septal trabeculations, and the shape of the ventricles. Angiocardiographic recognition of the ventricles was achieved on the basis of right and left ven-triculography.In one case with usual atrial arrangement, we recorded two His bundle potentials, one anteriorly and another posteriorly. Atrial stimulation revealed blocked atrioventricular conduction at the level of the pos terior bundle, and normal atrioventricular conduction through the anterior bundle. In both cases with atrial mirror-imagery, only a posterior His bundle potential was found, with normal atrioventricular conduction revealed by atrial stimulationThe clinical course with this combination depends on the other lesions present in addition to the common atrioventricular valve. Our electrophysiological studies show that the conduction system in presence of a common atrioventricular valve is as expected for congenitally corrected transposition with two atrioventric ular valves.


Circulation ◽  
1969 ◽  
Vol 40 (1) ◽  
pp. 61-69 ◽  
Author(s):  
ANTHONY N. DAMATO ◽  
SUN H. LAU ◽  
ROBERT D. PATTON ◽  
CHARLES STEINER ◽  
WALTER D. BERKOWITZ

1981 ◽  
Vol 59 (11) ◽  
pp. 1192-1195
Author(s):  
Peter E. Dresel ◽  
Keith D. Cameron

The effects of disopyramide (DP) and a new antiarrhythmic agent, disobutamide (DB) on cardiac conduction were studied using His bundle recording from modified rabbit Langendorff preparations electrically driven at 3 and 4 Hz. Both disopyramide (4–16 μg/mL) and disobutamide (1–30 μg/ml) slowed conduction throughout the atrioventricular conduction system, i.e., SA, AH, and HV intervals were increased in a dose-related manner. Conversion of the conduction time changes to percent changes indicates that disobutamide has a relatively equal effect on each part of the system whereas disopyramide exhibited significantly less effect on AV nodal conduction. Slowing of conduction in the AV node by DP was clearly related to rate. Changes in SA and HV intervals were rate related to a lesser degree. No such rate-related effect was evident with disobutamide. Block of atrial conduction occurred in two out of six hearts when the rate was increased at 8 μg/mL of DP and in three additional hearts at 16 μg/mL. This was interpreted to indicate a change in atrial excitability such that 2 × threshold currents no longer excited the tissues. This was not observed at any concentration of DB.


1974 ◽  
Vol 33 (3) ◽  
pp. 333-343 ◽  
Author(s):  
Masood Akhtar ◽  
Anthony N. Damato ◽  
Anthony R. Caracta ◽  
William P. Batsford ◽  
Mark E. Josephson ◽  
...  

Circulation ◽  
1969 ◽  
Vol 39 (3) ◽  
pp. 287-296 ◽  
Author(s):  
ANTHONY N. DAMATO ◽  
SUN H. LAU ◽  
RICHARD H. HELFANT ◽  
EMANUEL STEIN ◽  
WALTER D. BERKOWITZ ◽  
...  

2018 ◽  
Vol 3 (48) ◽  
pp. 24-27
Author(s):  
Agnieszka Wojdyła-Hordyńska ◽  
Grzegorz Hordyński ◽  
Pavel Dąbrowski ◽  
Tomasz Pawlik ◽  
Agata Kubal-Tkocz ◽  
...  

His bundle pacing (HBP) synchronizes atrio-ventricular and intraventricular delays. We observed the relationship between the level of atrio-ventricular block, ventricles synchrony, diastolic function improvement in a patient with moderate systolic disorders and diastolic dysfunction after myocardial infarction. HBP may be useful to treat conduction disorders and prevent further systolic and diastolic dysfunction. We present the case of a 92-year-old man in a very good general psychophysical status, treated with percutaneous coronary intervention of circumferential branch of left coronary artery angioplasty due to myocardial infarction, regional contractility disorders of left ventricle with ejection fraction (LVEF) 45%, and observed long PR interval with paroxysmal second degree atrioventricular conduction block. A successful implantation of a permanent HBP lead in the postinfarction period was performed. The His bundle capture restored AV synchrony and diminished diastolic disorders. Our case demonstrates that atrioventricular conduction disorders in the course of myocardial infarction may be corrected by HBP.


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