Spontaneous Transition of 2:1 Atrioventricular Block to 1:1 Atrioventricular Conduction during Atrioventricular Nodal Reentrant Tachycardia: Evidence Supporting the Intra-Hisian or Infra-Hisian Area as the Site of Block

Shih Huang Lee, Ching Tai Tai, Chern En Chiang, Wen Chung Yu, Jun Jack Cheng, Yu An Ding, Mau Song Chang, Shih Ann Chen

研究成果: 雜誌貢獻文章同行評審

17 引文 斯高帕斯(Scopus)

摘要

Introduction: The incidence of spontaneous transition of 2:1 AV block to 1:1 AV conduction during AV nodal reentrant tachycardia has not been well reported. Among previous studies, controversy also existed about the site of the 2:1 AV block during AV nodal reentrant tachycardia. Methods and Results: In patients with 2:1 AV block during AV nodal reentrant tachycardia, the incidence of spontaneous transition of 2:1 AV block to 1:1 AV conduction and change of electrophysiologic properties during spontaneous transition were analyzed. Among the 20 patients with 2:1 AV block during AV nodal reentrant tachycardia, a His-bundle potential was absent in blocked beats during 2:1 AV block in 8 patients, and the maximal amplitude of the His-bundle potential in the blocked beats was the same as that in the conducted beats in 4 patients and was significantly smaller than that in the conducted beats in 8 patients (0.49 ± 0.25 mV vs 0.16 ± 0.07 mV, P = 0.007). Spontaneous transition of 2:1 AV block to 1:1 AV conduction occurred in 15 (75%) of 20 patients with 2:1 AV block during AV nodal reentrant tachycardia. Spontaneous transition of 2:1 AV block to 1:1 AV conduction was associated with transient right and/or left bundle branch block. The 1:1 AV conduction with transient bundle branch block was associated with significant His-ventricular (HV) interval prolongation (66 ± 19 ms) compared with 2:1 AV block (44 ± 6 ms, P < 0.01) and 1:1 AV conduction without bundle branch block (43 ± 6 ms, P < 0.01). Conclusion: The 2:1 AV block during AV nodal reentrant tachycardia is functional; the level of block is demonstrated to be within or below the His bundle in a majority of patients with 2:1 AV block during AV nodal reentrant tachycardia, and a minority are possibly high in the junction between the AV node and His bundle.

原文英語
頁(從 - 到)1337-1341
頁數5
期刊Journal of Cardiovascular Electrophysiology
14
發行號12
DOIs
出版狀態已發佈 - 十二月 2003
對外發佈

ASJC Scopus subject areas

  • 心臟病學與心血管醫學
  • 生理學(醫學)

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