Clinical and electrocardiographic features and long-term results of electrical therapy in patients with isolated His bundle disease

• Published in: The American heart journal Vol. 112; no. 6; p. 1183
• Main Authors: Mangiardi, L M, Ronzani, G, Gaita, F, Presbitero, P, Conte, M R, Di Leo, M, Commodo, E, Brusca, A
• Format: Journal Article
• Language: English
• Published: United States 01-12-1986
• Subjects: Adult; Aged; Aged, 80 and over; Bundle of His - physiopathology; Bundle-Branch Block - diagnosis; Bundle-Branch Block - physiopathology; Bundle-Branch Block - therapy; Cardiac Pacing, Artificial; Electrocardiography; Female; Follow-Up Studies; Humans; Male; Middle Aged; Pacemaker, Artificial
• ISSN: 0002-8703
• DOI: 10.1016/0002-8703(86)90347-9

The clinical, ECG, and electrophysiologic findings of 35 consecutive patients with second- and third-degree intra-His block with normal QRS complexes were examined. The follow-up period varied between 12 and 120 months (mean 45). Seventy-seven per cent of the patients were women. Underlying heart disease was present in 43% of the patients. ECGs were characterized by both second-degree type I and type II atrioventricular block, normal or slightly prolonged PR interval of the conducted beats or of the first conducted beat of a Wenckebach sequence, and by subtle changes in the initial forces of the QRS complexes of the escape beats. Electrophysiologic study showed normal sinus and atrioventricular node function and normal infra-His conduction in all patients. In four patients repetitive bradycardia-dependent intra-His block was induced. Thirty-two patients were permanently paced soon after the initial evaluation and three during the follow-up period. Total long-term mortality rate was 23%. None of the patients developed bundle branch block.