Concealed intraventricular conduction in the His bundle electrogram.

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.

journal_name

Circulation

journal_title

Circulation

authors

Cohen HC,D'Cruz I,Pick A

doi

10.1161/01.cir.53.5.776

subject

Has Abstract

pub_date

1976-05-01 00:00:00

pages

776-83

issue

5

eissn

0009-7322

issn

1524-4539

journal_volume

53

pub_type

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