Document Detail


The RR index test for the differentiation of atrioventricular nodal block from His-Purkinje block during incremental atrial pacing in patients with bifascicular block.
MedLine Citation:
PMID:  9043848     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: His-Purkinje block induced by incremental atrial pacing is highly predictive of an impending high degree atrioventricular block in patients with bifascicular block. The His potential is, however, sometimes not measurable or is lost in the ventricular depolarization. The aim of this study was to evaluate whether the comparison of RR intervals before and after atrioventricular block, induced by incremental atrial pacing, could differentiate between atrioventricular nodal and His-Purkinje block in patients with bifascicular block. METHODS AND RESULTS: In 98 patients, with bifascicular block, incremental atrial pacing was performed as part of an invasive electrophysiological study. An "RR index' was constructed by calculating the numerical difference between the RR interval immediately before and after the atrioventricular block divided by the RR interval immediately before the pacing induced block. Endocavitary recording of the His bundle potential was used for defining the level of atrioventricular block. The median RR index was 0.98 (range 0.88-1.02) in recordings with His-Purkinje block and 0.49 (range 0.11-0.89) in recordings with atrioventricular nodal block (P < 0.001). An RR index of > or = 0.85 had a sensitivity of 100% and a specificity of 99% for the identification of atrioventricular block localized to the His Purkinje system. CONCLUSION: The use of an RR index is a helpful tool in the differentiation of His-Purkinje from atrioventricular nodal block in patients with bifascicular block undergoing incremental atrial pacing as part of an invasive electrophysical study.
Authors:
A Englund
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European heart journal     Volume:  18     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  1997 Feb 
Date Detail:
Created Date:  1997-05-05     Completed Date:  1997-05-05     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  311-7     Citation Subset:  IM    
Affiliation:
Karolinska Institute, Department of Cardiology, Karolinska Hospital, Stockholm, Sweden.
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MeSH Terms
Descriptor/Qualifier:
Aged
Bundle of His / pathology*,  physiopathology
Bundle-Branch Block / diagnosis*,  physiopathology,  therapy
Cardiac Pacing, Artificial / adverse effects
Chronic Disease
Diagnosis, Differential
Electrocardiography / methods*
Female
Heart Block / diagnosis*,  etiology,  physiopathology
Heart Catheterization
Humans
Male
Purkinje Fibers / pathology*,  physiopathology
Sensitivity and Specificity

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


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