[Pathologic changes of the cardiac conduction system in 12 patients with abnormal ECG].
OBJECTIVE
To investigate the relationship between abnormal ECG and pathologic changes in the cardiac conduction system (CCS).


METHODS
Pathological changes of the CCS in 12 cases with abnormal ECG out of 16 pre-death ECG were observed.


RESULTS
(1) Among 7 cases of sudden cardiac death, ECG monitoring recorded bradyarrhythmia in 6 cases, tachyarrhythmia 6 cases, bradycardia-tachycardia syndrome 2 cases, conduction block 6 cases, atrial premature beats 6 cases, ventricular premature beats 6 cases, and ST-T changes 4 cases. (2) The histopathological findings in the CCS were noted in all cases. Of these 12 cases, three had signs of fatty infiltration, and/or fibrous 4 cases, three of amyloidosis, one of chronic inflammatory changes, two of acute inflammatory changes, two of developmental anomalies, two of hemorrhages and one of LAD stenosis. (3) Acute inflammation changes in the CCS corresponded to tachyarrhythmia and multiple ventricular premature beats, whereas chronic inflammation and degenerative changes in the CCS were often related to bradyarrhythmia, bradycardia-tachycardia syndrome and conduction block. (4) The CCS changes alone could lead to ST-T changes in ECG.


CONCLUSIONS
The pathological changes in the CCS are related to ECG changes, and attributed to the pathological bases of arrhythmia.
Song
Yi-xuan
YX
Department of Forensic Medicine, Medical College of Sun Yat-sen University, Guangzhou 510080, China.
Yao
Qing-song
QS
Gao
Xiu-ren
XR
Luo
Bin
B
D000293:Adolescent; D000328:Adult; D000368:Aged; D001145:Arrhythmias, Cardiac / Q000473:pathology* / Q000503:physiopathology*; D002648:Child; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000473:pathology* / Q000503:physiopathology; D006801:Humans; D008297:Male; D008875:Middle Aged; D055815:Young Adult