Document Detail

Prospective evaluation of infrahisal second-degree AV block induced by atrial pacing in the presence of chronic bundle branch block and syncope.
MedLine Citation:
PMID:  8734745     Owner:  NLM     Status:  MEDLINE    
The value of nonfunctional infrahisal second-degree atrioventricular (AV) block induced by incremental atrial pacing was prospectively examined in 192 patients with chronic bundle branch block (BBB) and syncope. We compared 174 (91%) patients with normal response to atrial pacing (Group I) to 18 (9%) patients with atrial pacing induced nonfunctional infrashisal second-degree AV block (Group II). Patients in group I had higher incidence of organic heart disease, ventricular tachycardia induction, and retrograde ventriculoatrial conduction (P < 0.001, P < 0.05, P < 0.01, respectively), while patients in group II had higher incidence of primary conduction disease and prolonged H-V intervals (P < 0.001, P < 0.01, and P < 0.001). During mean follow-up period of 65 +/- 34 months for group I, and 68 +/- 35 months for group II, a development of spontaneous second- or third-degree AV block was higher in group II (14/18 [78%]), than in group I (15/174 [9%]) (P < 0.001). The site of AV block was infrahisal in all patients in group II, and in 10 of 15 patients in group I. Because of the prophylactic pacing in all patients in group II, the incidence of sudden death was similar among the two groups, but patients in group I had higher incidence of cardiac death (P < 0.05). Conclusion: In patients with chronic BBB and syncope, a nonfunctional infrashisal AV block induced by incremental atrial pacing identified patients with particularly high risk of development of spontaneous infrahisal AV block. Therefore, permanent cardiac pacing is absolutely indicated in these patients.
D Petrac; B Radić; K Birtić; J Gjurović
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  19     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  1996 May 
Date Detail:
Created Date:  1996-10-21     Completed Date:  1996-10-21     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  784-92     Citation Subset:  IM    
Department of Cardiology, University Hospital Sestre Milosrdnice, Zagreb, Croatia.
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MeSH Terms
Aged, 80 and over
Arrhythmias, Cardiac / complications
Bundle of His / physiopathology*
Bundle-Branch Block / complications,  therapy*
Cardiac Pacing, Artificial / adverse effects*,  methods
Death, Sudden, Cardiac / etiology
Evaluation Studies as Topic
Follow-Up Studies
Heart Atria
Heart Block / classification,  etiology*
Heart Diseases / complications
Middle Aged
Prospective Studies
Risk Factors
Syncope / complications,  therapy*
Tachycardia, Ventricular / complications

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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