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His bundle block and concealed His bundle premature depolarization

J P Donzeau, P Bernadet, J P Bounhoure

    European Journal of Cardiology
    |January 1, 1979
    PubMed
    Summary
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    Unexplained PR interval changes may indicate a "Sick His bundle syndrome." This condition involves concealed His bundle depolarizations, leading to conduction disturbances like heart block.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Electrophysiology

    Background:

    • Atrioventricular (AV) block is a common cardiac arrhythmia.
    • PR interval abnormalities on electrocardiograms can suggest AV block.
    • His bundle electrocardiography is crucial for diagnosing complex conduction disturbances.

    Observation:

    • A patient presented with unexplained PR prolongations/shortenings, mimicking Type I and II second-degree AV block.
    • His bundle electrocardiograms revealed concealed His bundle depolarizations (H") not propagating to the atria or ventricles.
    • These depolarizations were associated with first-degree AV block within the His bundle itself.

    Findings:

    • The observed conduction disturbances were attributed to the combination of concealed His bundle depolarizations and first-degree AV block.

    Related Experiment Videos

  • Frequent spontaneous His bundle depolarizations were identified as a key factor.
  • This suggests a distinct pathological process affecting the His bundle.

    • Implications:

    • Frequent spontaneous His bundle depolarizations may represent a novel manifestation of His bundle disease, termed "Sick His bundle syndrome."
    • This syndrome offers a new perspective on understanding unexplained AV conduction abnormalities.
    • Further research into "Sick His bundle syndrome" could refine diagnostic and therapeutic strategies for cardiac arrhythmias.