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Related Experiment Videos

The anatomic substrate for preexcitation in corrected transposition

S Bharati, K Rosen, L Steinfield

    Circulation
    |October 1, 1980
    PubMed
    Summary

    This study found that ventricular preexcitation in corrected transposition with Ebstein's anomaly is linked to Kent bundles. Intermittent preexcitation and AV block suggest tenuous Kent bundles and conduction system discontinuity.

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    Area of Science:

    • Cardiology
    • Electrophysiology
    • Congenital Heart Disease

    Background:

    • Corrected transposition (CT) is a complex congenital heart defect.
    • Ebstein's anomaly involves malformation of the tricuspid valve.
    • Ventricular preexcitation can occur in CT, indicating accessory pathways.

    Purpose of the Study:

    • To investigate the association between ventricular preexcitation and cardiac anomalies in CT.
    • To characterize the electrophysiological findings and anatomical substrates in three cases.

    Main Methods:

    • Electrocardiogram (ECG) analysis for preexcitation patterns.
    • Complete serial section (SS) of the conduction system (CS).
    • Detailed anatomical correlation of accessory pathways (Kent bundles) and conduction system abnormalities.

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    Main Results:

    • Cases 1 and 2 showed sinus rhythm with fusion complexes suggesting left-sided Kent bundles and intact CS.
    • Serial section revealed anterior CS and posteroseptal Kent bundle in the morphologic right ventricle (MRV).
    • Case 3 presented intermittent preexcitation with AV block, linked to a left lateral Kent bundle, discontinuous CS, and a tenuous posterolateral Kent bundle in the MRV.

    Conclusions:

    • Ventricular preexcitation in CT with Ebstein's disease is associated with Kent bundles.
    • Fusion complexes correlate with an intact conduction system.
    • Intermittent preexcitation and AV block are linked to tenuous Kent bundles and conduction system discontinuity.