Document Detail

Electrophysiological delineation of the specialized conduction system under cardiotomy and its clinical role.
MedLine Citation:
PMID:  7120649     Owner:  NLM     Status:  MEDLINE    
Electrophysiological delineation of the specialized conduction system was performed under cardiotomy on 64 patients: 51 with ventricular septal defect (VSD), 11 with tetralogy of Fallot (TOF) and 2 with transposition of the great arteries (TGA, III). Some histological study was done for confirmation. In large VSD of type II or III, superficial location of the His bundle was shown by a tall H deflection recorded along the inferior rim, coinciding with a high incidence of conduction disturbance in this malformation. One characteristic in TOF was a deflection recorded along the posteroinferior rim rather exclusively on the left ventricular side, coinciding with the anatomic course of the His bundle. A deflection was frequently recorded at an area a few mm posterior to the muscle of Lancisi (ML) or the Lancisi equivalent structure (LES); it was relatively common in ordinary types of VSD, and presumed as the penetrating site of the right bundle branch (RBB) and/or near the bifurcated portion of the His bundle. The second portion of the RBB was not clearly delineated in general, particularly in TOF, but always found within the septomarginal trabecle when delineated. Our conclusion, together with histological study, was that one may use the ML or the LES as a rough marking for the course of the RBB. By this recognition, the surgically induced complete right bundle branch block has been diminished significantly. Variation of the course of conduction system as well as limits of this diagnostic measure are described herein.
T Tamiya; T Yamashiro; T Matsumoto; A Takemasa
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Japanese circulation journal     Volume:  46     ISSN:  0047-1828     ISO Abbreviation:  Jpn. Circ. J.     Publication Date:  1982 Oct 
Date Detail:
Created Date:  1982-12-03     Completed Date:  1982-12-03     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7806868     Medline TA:  Jpn Circ J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  1051-8     Citation Subset:  IM    
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MeSH Terms
Bundle of His / physiopathology
Cardiac Surgical Procedures*
Child, Preschool
Heart Conduction System / physiopathology*
Heart Defects, Congenital / physiopathology*,  surgery
Heart Septal Defects, Ventricular / physiopathology,  surgery
Tetralogy of Fallot / physiopathology,  surgery
Transposition of Great Vessels / physiopathology,  surgery

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