Appraisal of the Intraventricular Conduction Defects as Studied by His Bundle Recordings

Ectopic foci associated with aberrant intraventicular conduction (AIVC) may either be ventricular foci or supraventricular foci. The electrocardiogram may not help in this differentiation. Knowledge of the site of origin is essential to determine appropriate therapy for patients who develop sustained tachycardias and may be of prognostic value in those who have frequent premature contractions. To determine the site of the ectopic focus, His bundle electrograms were performed in seven children whose conventional ECGs showed arrhythmias with frequent premature ectopic beats and runs of bigeminy with AIVC. In two patients the focus was in the supraventricular area while the other five had a ventricular focus. Incomplete right bundle branch block was noted in one patient with a supraventricular focus but complete bundle branch block occurred in both patients with both ventricular and supraventricular foci.

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Electrophysiologic demonstration of anterograde fast and slow pathways within the His bundle in patients with normal intraventricular conduction

International Journal of Cardiology ◽

10.1016/0167-5273(94)90289-5 ◽

1994 ◽

Vol 44 (3) ◽

pp. 251-260 ◽

Cited By ~ 3

Author(s):

Osmar Antonio Centurion ◽

Shojiro Isomoto ◽

Atsushi Konoe ◽

Akihiko Shimizu ◽

Motonobu Hayano ◽

...

Keyword(s):

Intraventricular Conduction ◽

His Bundle

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HIS bundle electrocardiogram in children with secundum atrial defects and patent ductus arteriosus

Paediatrica Indonesiana ◽

10.14238/pi21.1-2.1981.1-10 ◽

1981 ◽

Vol 21 (1-2) ◽

pp. 1

Author(s):

Bambang Madiyono ◽

Hanafi B. Trisnohadi ◽

Maemunah Affandi

Keyword(s):

Patent Ductus Arteriosus ◽

Cardiac Catheterization ◽

Ductus Arteriosus ◽

Bundle Branch Block ◽

Intraventricular Conduction ◽

His Bundle ◽

Children With Asd ◽

His Bundle Electrocardiogram ◽

Ventricular Conduction ◽

Patent Ductus

The purpose of this swdy is to compare intra-atrial conduction (atrio-ventricular conduction and intraventricular conduction) in children with secundum atrial deptal defect (ASD II) and patent ductus arteriosus (PDA) using His bundle electrocardiogram (HBE).Six patienls with ASD II and seven with PDA, aged ranging from 3 to 11 years were included in the study. The diagnoses of all cases were confirmed by cardiac catheterization. The results of HBE studies showed that the PA, AH, HV, interval in ASD II were 31.7 ± 7.6 msec; 65.8 ± 16.8 msec; 42.5 ± 2.2 msec; and in eDA were 25 ± 7.8 msec; 77.9 ± 9.4 msec; 40 ± 3.8 I11sec respectively. The differences were statistically not significant (P > 0.05).The data showed that intra-atrial conduction in children with ASD II was not longer than that in PDA and also there was no difference in atrioventricular conduction and intraventricular conduction, although childrell with ASD II usually have abnormal ECG, like right bundle branch block.

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MAPS of Ventricular Activation Time (VAT) Differences in Children on Peritoneal Dialysis — a Pilot Study

Peritoneal Dialysis International ◽

10.3747/pdi.2013.00067 ◽

2015 ◽

Vol 35 (2) ◽

pp. 140-146

Author(s):

Krystyna Laszki-Szcząchor ◽

Dorota Polak-Jonkisz ◽

Danuta Zwolińska ◽

Ewa Salomon ◽

Henryk Filipowski ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Conduction System ◽

Control Group ◽

Healthy Children ◽

Activation Time ◽

Intraventricular Conduction ◽

His Bundle ◽

Group I ◽

Ventricular Activation ◽

Esrd Patients

BackgroundDecrement of glomerular filtration rate leads to many serious complications that cause both functional and structural impairments of the other organs. Long-term clinical observations of children and teenagers with end-stage renal disease (ESRD) showed that more than one third of those patients manifested various cardio-vascular conditions. The aim of the study was to analyze possible disturbances in the heart ventricular conduction system by using a technique of ventricular activation time (VAT) differences in ESRF children on peritoneal dialysis (PD) with normal electrocardiogram (ECG) examinations.Material and methodsThe study group comprised 10 ESRD children (mean age: 13.6 ± 2.31 years) on peritoneal dialysis – group I. The control group (group II) consisted of 26 age-matched healthy children with no clinical evidence of renal or cardiac disease and with normal 12-lead ECG recordings. Each of the ESRD patients was also subjected to the standard ECG examination. In order to capture possible heart conduction abnormalities, body surface potential mapping (BSPM) recordings were performed in PD patients between the successive dwells (‘on empty abdomen’) with a HPM-7100 Fukuda Denshi system. Based on the source ECG data, the original technique of a VAT difference map was then applied.ResultsDifferences between VAT values for the two examined groups of children, controls and ESRD patients on PD, were significantly pronounced in the region of the right upper anterior thorax, the entire left thorax and nearly in the total back. Such a pattern of VAT delays indicates a pathological electric transmission in the intraventricular conduction system of the left anterior fascicle of His bundle.Conclusion1. VAT maps (isochrone maps) can be useful to detect abnormal spreading and depolarization through the heart ventricles. 2. Map of VAT value differences makes it possible to identify early disturbances in the left His bundle branch in ESRD children treated with peritoneal dialysis regardless of normal 12-lead ECG. 3. Further studies on a larger group of children with ESRD on PD are required to verify the preliminary observations presented herein.

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Study of intraventricular conduction times in patients with left bundle-branch block and left axis deviation and in patients with left bundle-branch block and normal QRS axis using His bundle electrograms.

Heart ◽

10.1136/hrt.34.12.1244 ◽

1972 ◽

Vol 34 (12) ◽

pp. 1244-1249 ◽

Cited By ~ 24

Author(s):

R A Spurrell ◽

D M Krikler ◽

E Sowton

Keyword(s):

Left Bundle Branch Block ◽

Axis Deviation ◽

Bundle Branch Block ◽

Intraventricular Conduction ◽

His Bundle

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Electrocardiographic characterization of non-selective His bundle pacing. Validation of novel diagnostic criteria

10.1101/631481 ◽

2019 ◽

Cited By ~ 1

Author(s):

Marek Jastrzębski ◽

Paweł Moskal ◽

Karol Curila ◽

Kamil Fijorek ◽

Piotr Kukla ◽

...

Keyword(s):

Sensitivity And Specificity ◽

Left Ventricular ◽

Peak Time ◽

List Type ◽

Intraventricular Conduction ◽

His Bundle ◽

His Bundle Pacing ◽

Conduction Disturbances ◽

Surface Ecg ◽

Ecg Criteria

AbstractAimsPermanent His bundle (HB) pacing is usually accompanied by simultaneous capture of the adjacent right ventricular (RV) myocardium - this is described as a non-selective (ns)-HB pacing. Our aim was to identify ECG criteria for loss of HB capture during ns-HB pacing.MethodsConsecutive patients with permanent HB pacing were recruited. Surface 12-lead ECGs during ns-HB pacing and loss of HB capture (RV-only capture) were obtained. ECG criteria for loss/presence of HB capture were identified. In the validation phase these criteria and the “HB ECG algorithm” were tested by two blinded observers using a separate, sizable set of ECGs.ResultsA total of 353 ECG (226 ns-HB and 128 RV-only) were obtained from 226 patients with permanent HB pacing devices. QRS notch/slur in left ventricular leads and R-wave peak time in lead V6 were identified as the best features for differentiation. The 2-step HB ECG algorithm based on these features correctly classified 87.1% of cases with sensitivity and specificity of 93.2% and 83.9%, respectively. Moreover, the proposed criteria for definitive diagnosis of ns-HB capture (no QRS slur/notch in leads I, V1, V4-V6 and the R-wave peak time in V6 ≤ 100 ms) presented 100% specificity.ConclusionA novel ECG algorithm for the diagnosis of loss of HB capture and novel criteria for definitive confirmation of HB capture were formulated and validated. Practical application of these criteria during implant and follow-up of patients with HB pacing devices is feasible.Condensed AbstractThe 2-step ECG algorithm for loss of His bundle capture based on surface ECG analysis is proposed and validated. This method correctly classified 87.1% of cases with a sensitivity and specificity of 93.2% and 83.9%, respectively.What’s NewThis is the first study that analyzes QRS characteristics during non-selective His bundle pacing in a sizable cohort of patients.Precise criteria and a novel algorithm for electrocardiographic diagnosis of loss of HB capture during presumed non-selective HB pacing were validated.QRS notch/slur in left ventricular leads was identified as a simple and reproducible feature indicating loss of HB capture or lack/loss of correction of intraventricular conduction disturbances.Assessment of R-wave peak time in lead V6 rather than QRS duration for diagnosis of ns-HB pacing was validated.

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