HIS bundle electrogram in rheumatic mitral valve disease with special reference to Bachmann's bundle block in P...

Area of Science:

• Cardiology
• Electrophysiology
• Cardiac Electrophysiology

Background:

• Chronic rheumatic mitral stenosis can be associated with complex cardiac electrical abnormalities.
• Understanding atrial conduction disturbances is crucial for managing valvular heart disease.

Purpose of the Study:

• To investigate atrial conduction patterns in patients with chronic rheumatic mitral stenosis using His bundle electrograms (HBEs).
• To identify the prevalence and characteristics of Bachmann's bundle block in this patient cohort.

Main Methods:

• His bundle electrograms (HBEs) were recorded during cardiac catheterization in 26 patients with mitral stenosis.
• Analysis focused on the P wave termination, P2H interval, and atrial activities (A and A' waves).
• Interatrial conduction time (P1A' interval) was measured in patients with identifiable double atrial activities.

Main Results:

• Bachmann's bundle block, characterized by a negative P2H interval, was observed in 12 of 15 patients with sinus rhythm.
• Prolonged interatrial conduction time (P1A' interval) was present in all 7 patients with identifiable double atrial activities.
• No correlation was found between conduction intervals and left atrial enlargement or hemodynamic parameters.

Conclusions:

• Bachmann's bundle block and prolonged interatrial conduction are common findings in patients with chronic rheumatic mitral stenosis.
• These electrophysiological abnormalities may contribute to the complex cardiac electrical behavior observed in mitral stenosis.