Clinical and electrocardiographic features and long-term results of electrical therapy in patients with isolated His bundle disease.
The clinical, ECG, and electrophysiologic findings of 35 consecutive patients with second- and third-degree intra-His block with normal QRS complexes were examined. The follow-up period varied between 12 and 120 months (mean 45). Seventy-seven per cent of the patients were women. Underlying heart disease was present in 43% of the patients. ECGs were characterized by both second-degree type I and type II atrioventricular block, normal or slightly prolonged PR interval of the conducted beats or of the first conducted beat of a Wenckebach sequence, and by subtle changes in the initial forces of the QRS complexes of the escape beats. Electrophysiologic study showed normal sinus and atrioventricular node function and normal infra-His conduction in all patients. In four patients repetitive bradycardia-dependent intra-His block was induced. Thirty-two patients were permanently paced soon after the initial evaluation and three during the follow-up period. Total long-term mortality rate was 23%. None of the patients developed bundle branch block.
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002036:Bundle of His / Q000503:physiopathology; D002037:Bundle-Branch Block / Q000175:diagnosis* / Q000503:physiopathology / Q000628:therapy; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial