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  • 1
    Electronic Resource
    Electronic Resource
    Histopathologic Exploration of Intra-Hisian Conduction Disturbances (2002)
    Oxford, UK : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 13 (2002), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Pathology of Intra-Hisian Block. Introduction: The length of the His bundle and the precise location of injury responsible for split His potentials have not been fully established in patients with intra–Hisian block. We conducted an autopsy study comparing histologic findings in intra-Hisian block versus control hearts. Methods and Results: We studied hearts from 4 intra-Hisian block patients (age 66 to 93 years, mean 79.5) and hearts from 14 patients without AV conduction abnormalities (control). All intra-Hisian block patients underwent electrophysiologic evaluation; 3 patients demonstrated intra-Hisian block and 1 showed no His potential. Autopsies were performed when each patient died. After the heart was fixed in formaldehyde, the AV septal junctional area was removed en bloc and serially sectioned into 7-μm thick slices. For study purposes, we considered the three segments of the His bundle separately: the penetrating bundle, the nonbranching bundle, and the branching bundle. The actual length of each segment was calculated from the number of respective serial sections, and the lesion was reconstructed within the conduction axis. Intra-Hisian block hearts were heavier than control hearts (mean weight 389 vs 301 g; P 〈 0.05). The lesion was situated in the nonbranching bundle in 3 hearts and in the penetrating bundle in 1 heart. Mean compact node length was 3.8 mm in intra-Hisian block hearts and 3.3 mm in control hearts. The penetrating bundle was 2.1 and 2.1 mm, the nonbranching bundle was 3.5 and 1.9 mm, and the branching bundle was 4.5 and 4.6 mm in intra-Hisian block and control hearts, respectively. Conclusion: Most lesions were observed in the nonbranching bundle adjacent to the junction between the central fibrous body and ventricular septum. This segment was longer in intra-Hisian block hearts than in control hearts.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2002.00257.x
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    Paper (German National Licenses)
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  • 2
    Electronic Resource
    Electronic Resource
    Bone Marrow Observed in Radiofrequency Ablation Scar Tissue (2005)
    350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Journal of cardiovascular electrophysiology 16 (2005), S. 0 
    Details
    ISSN: 1540-8167
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1046/j.1540-8167.2005.40636.x
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    Paper (German National Licenses)
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  • 3
    Electronic Resource
    Electronic Resource
    Prolonged Paced QRS Duration as a Predictor for Congestive Heart Failure in Patients with Right Ventricular Apical Pacing (2005)
    350 Main Street , Malden , MA 02148-5018 , USA and 9600 Garsington Road , Oxford OX4 2DQ , UK . : Blackwell Science Inc
    Pacing and clinical electrophysiology 28 (2005), S. 0 
    Details
    ISSN: 1540-8159
    Source: Blackwell Publishing Journal Backfiles 1879-2005
    Topics: Medicine
    Notes: Background: The recent studies showed that right ventricular (RV) pacing was associated with worsening of heart failure. The aim of this study is to clarify the clinical significance of paced QRS duration during RV pacing to predict congestive heart failure (CHF) patients. Methods and Results: This study enrolled in 92 patients with atrioventricular block who underwent initial pacemaker implantation. The paced QRS duration was automatically obtained by electrocardiography immediately after pacemaker implantation and then by routine attendance at a pacemaker clinic every 3 months. The paced QRS duration was positively correlated with left ventricular end-diastolic dimension (P 〈 0.05) and left ventricular end-systolic dimension (P 〈 0.05), and tended to negatively correlate with left ventricular ejection fraction (P = 0.0507). The paced QRS duration immediately after pacemaker implantation was 170.4 ± 18.9 ms. During a mean follow-up period of 53 ± 16 months, 16 patients developed CHF. We selected as a cut-off value the nearest whole number (190 ms) that was one standard deviation greater than the mean, and divided into two groups according to baseline paced QRS duration. Patients with a paced QRS duration of 〈190 ms comprised group A (n = 77, nine of which developed CHF) and the remainder comprised group B (n = 15, seven of which developed CHF). Prolonged paced QRS duration (≥190 ms) was associated with a significant increase in the overall morbidity of CHF (P 〈 0.05). Additionally, paced QRS duration significantly prolonged during the follow-up period among group A patients with CHF (P 〈 0.05), but did not change among patients without CHF. Conclusion: We concluded that paced QRS duration can be a useful indicator of impaired left ventricular function in patients with RV pacing. Even in patients whose paced QRS duration is relatively shorter, progressive prolongation of paced QRS duration can predict the development of CHF.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1111/j.1540-8159.2005.50181.x
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    Paper (German National Licenses)
    Fulltext
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