Document Detail

Retrograde migration of the site of functional block: a mechanism underlying resolution of functional retrograde bundle branch block during AV reentrant tachycardia.
MedLine Citation:
PMID:  8777481     Owner:  NLM     Status:  MEDLINE    
INTRODUCTION: Functional bundle branch blocks during supraventricular tachycardia have been described, and their sustainment has been attributed to concealed conduction. Such blocks frequently resolve spontaneously, but the electrophysiologic mechanism of resolution has not been well described. This report describes the resolution of functional bundle branch block through proximal migration of the site of block. METHODS AND RESULTS: During electrophysiologic study of a patient with reentrant antidromic tachycardia via an atriofascicular accessory pathway, functional retrograde right bundle branch block could be readily induced following tachycardia initiation with right ventricular apical pacing. Resolution of this block was associated with shortening of the tachycardia cycle length. Electrogram recordings along the right bundle branch during tachycardia determined that resolution of the functional retrograde right bundle branch block was associated with migration of the site of block from the distal to the proximal right bundle. When the site of block was directly at the recording site, both anterograde and retrograde activation of the right bundle was demonstrated. CONCLUSION: Migration of the site of block is a mechanism of resolution for functional conduction blocks maintained by concealed conduction.
P J Tchou; R Trohman; G Kidwell; A A Mehdirad
Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular electrophysiology     Volume:  7     ISSN:  1045-3873     ISO Abbreviation:  J. Cardiovasc. Electrophysiol.     Publication Date:  1996 Apr 
Date Detail:
Created Date:  1996-09-19     Completed Date:  1996-09-19     Revised Date:  2010-03-24    
Medline Journal Info:
Nlm Unique ID:  9010756     Medline TA:  J Cardiovasc Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  335-40     Citation Subset:  IM    
Department of Cardiology, Cleveland Clinic Foundation, OH 44195, USA.
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MeSH Terms
Bundle-Branch Block / physiopathology*,  therapy
Cardiac Pacing, Artificial
Catheter Ablation
Heart Conduction System / physiopathology
Tachycardia, Atrioventricular Nodal Reentry / physiopathology*,  therapy
Ventricular Premature Complexes / physiopathology

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