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Electrophysiologic and histologic correlations in chronic complete atrioventricular block
Circulation
|August 1, 1981
Summary
Chronic complete atrioventricular block (CAVB) with AH block can stem from His bundle lesions. CAVB with HV block indicates bilateral bundle branch disease, correlating electrophysiology with histology.
Area of Science:
- Cardiology
- Electrophysiology
- Histopathology
Background:
- Chronic complete atrioventricular block (CAVB) requires precise localization of conduction system disease.
- His bundle electrogram (HBE) and histologic examination are key diagnostic tools.
Observation:
- Two patient groups with CAVB were studied: Group 1 (narrow QRS, AH block) and Group 2 (wide QRS, HV block).
- Histology correlated with HBE findings to identify the precise location of conduction system lesions.
Findings:
- In Group 1 (AH block), lesions were found in the His bundle (penetrating or branching portions), not solely the AV node.
- In Group 2 (HV block), lesions consistently involved bilateral bundle branches, consistent with trifascicular block.
Implications:
- HBE findings of AH block in CAVB can indicate His bundle lesions.
- HV block in CAVB strongly suggests bilateral bundle branch disease.
- Correlating electrophysiologic and histologic data refines understanding of CAVB pathophysiology.