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Intra-His bundle block in acute myocardial infarction. Report of two cases
Insights
Acute intra-His bundle block, often caused by myocardial infarction, can lead to chronic heart rhythm issues. This condition highlights the His bundle
Area of Science:
- Cardiology
- Electrophysiology
- Cardiac Anatomy
Background:
- Intra-His bundle block is a rare but serious complication of myocardial infarction.
- Understanding the His bundle's electrical conduction is crucial for diagnosing and managing heart blocks.
Abstract:
Two patients with acute intra-His bundle block, both secondary to myocardial infarction, are described. The diagnosis of the block was proved by means of His bundle recordings during the phase of complete atrio-ventricular (A-V) block. Two His bundle potentials, one (H) following each A wave and the other (H') preceding each QRS complex, were detected. In both cases, as well as in the few cases reported in the literature, the site of the infarction was in the inferior wall, an occurrence which shows the functional importance of the posterior blood supply to the His bundle. In both cases the block developed into a chronic form, requiring the implantation of a transvenous pacemaker in one case. This evolution suggests that the post-infarction intra-His bundle block may be due to irreversible anatomic damage.