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The surface electrocardiogram in complete intra-his heart block.
Journal of Electrocardiology
|April 1, 1978
Summary
Surface ECG can predict intra-His versus supra-His heart block. Narrow QRS escape rhythms with abnormal septal depolarization suggest intra-His block, aiding diagnosis.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Diagnostics
Background:
- Distinguishing the level of heart block (intra-His vs. supra-His) is crucial for patient management.
- Surface electrocardiography (ECG) is a non-invasive tool used to assess cardiac electrical activity.
Observation:
- Five patients with third-degree heart block had block localized within the His bundle.
- Their surface ECG revealed escape rhythms with narrow QRS complexes (<0.10s).
- Abnormal initial QRS forces, specifically absent septal q waves in leads I and V6, were noted.
Findings:
- An escape rhythm with narrow QRS morphology but abnormal septal depolarization on surface ECG may indicate intra-His block.
- Two patients exhibited occasional conducted beats with normal septal q waves, highlighting variability.
Implications:
- This ECG pattern could serve as a predictive marker for intra-His block.
- Improved diagnostic accuracy for heart block levels can potentially refine treatment strategies.
- Further research validating these ECG findings in larger cohorts is warranted.