Analysis of surgically-induced right bundle branch block pattern using intracardiac recording techniques.
Using intracardiac recording techniques, His bundle (H) and right ventricular apical (RVA) electrograms were recorded in 16 patients with a postoperative electrocardiographic pattern of right bundle branch block (RBBB). Their ages ranged from 5 to 12 years (mean 6.9 years) at surgery and the follow-up period was 1 to 7 years (mean 2.7 years). All were asymptomatic and in sinus rhythm at the time of study. The P-A interval was normal in all and the A-H, H-V, and V-RVA intervals were prolonged in one, one, and six patients, respectively. The V-RNA interval was normal (less than or equal to 30 msec) in ten out of the 11 patients (91%) without associated left anterior hemiblock (LAH), indicating a physiologically intact main right bundle branch, and was abnormally lengthened (45-62 msec) in all five patients (100%) with associated LAH. These findings suggest that there are two subgroups of patients with surgicall-induced RBBB pattern and the measurement of the V-RVA interval in conjunction with the H-V interval may be of ultimate importance in understanding the long-term prognostic implication of surgically-induced RBBB pattern with or without LAH.
D002036:Bundle of His / Q000503:physiopathology; D002037:Bundle-Branch Block / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D004562:Electrocardiography; D005500:Follow-Up Studies; D006327:Heart Block / Q000503:physiopathology; D006345:Heart Septal Defects, Ventricular / Q000601:surgery; D006801:Humans; D011183:Postoperative Complications / Q000503:physiopathology*; D011379:Prognosis; D011690:Purkinje Fibers / Q000503:physiopathology; D009435:Synaptic Transmission; D013771:Tetralogy of Fallot / Q000601:surgery