Diagnosis of ventricular tachyarrhythmias by ambulatory electrocardiographic monitoring. Correlation with his bundle electrography.
The aim of the present study was to compare the prediction of bradyarrhythmias via the corrected sinus node recovery time and the His bundle electrogram with the findings made during long term electrocardiographic recording. Ninety-two patients, aged 17-88 years, were included in the study with a suspicion of Adams-Stokes' syndrome. During long term electrocardiographic recording only 40 patients had symptoms while 52 could not tolerate long term electrocardiographic recording until symptoms had appeared. Seven out 37 patients with sick sinus syndrome and 2 out of 9 with atrioventricular block 2 degrees/3 degrees had additional significant ventricular arrhythmias. A total of 10 patients had prolonged (greater than or equal to 160 msec) atrium to His intervals, among them 2 had significant ventricular arrhythmia but failed to have symptoms during long term electrocardiographic recording. In 22 patients the His to ventricle interval was moderately prolonged (56-79 msec), among them 7 had significant ventricular arrhythmias (5 with symptoms during long term electrocardiographic recording). Out of 5 patients with markedly H-V interval prolonged, 3 patients had 2 degrees/3 degrees atrio-ventricular block and 1 patient had atrial tachyarrhythmia during long term electrocardiographic recording. In conclusion prolonged H-V intervals are frequent in patients with episodic atrioventricular block but also in patients who have symptomatic ventricular tachyarrhythmias. Long term electrocardiographic recording is essential for the differentiation between symptomatic ventricular arrhythmia and symptomatic atrioventricular block in patients with prolonged HV-intervals.
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000175:diagnosis* / Q000503:physiopathology; D002036:Bundle of His / Q000503:physiopathology*; D004562:Electrocardiography / Q000295:instrumentation; D005260:Female; D006327:Heart Block / Q000175:diagnosis / Q000503:physiopathology; D006329:Heart Conduction System / Q000503:physiopathology*; D006352:Heart Ventricles; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000295:instrumentation*; D012804:Sick Sinus Syndrome / Q000175:diagnosis / Q000503:physiopathology