COMPARATIVE STUDY
JOURNAL ARTICLE

Intraventricular conduction in man studied with an endocardial electrode catheter mapping technique. Patients with normal QRS and right bundle branch block

J A Kastor, B N Goldreyer, E N Moore, J C Shelburne, J H Manchester
Circulation 1975, 51 (5): 786-96
1122581
The sequence of intraventricular conduction has been studied in a total of 60 patients, 38 of whom had normal QRS morphology and 37 of whom had right bundle branch block (RBBB) either present continuously or produced as functional aberrant RBBB by the introduction of atrial premature depolarizations or by rapid atrial pacing. Activation times were measured by intracardiac electrode catheters positioned at the right ventricular inflow tract (RVIT), right ventricular apex (RVA), right ventricular outflow tract (RVOT), left ventricular apex (LVA) and left ventricular outflow tract (LVOT). The activation after beginning of QRS in milliseconds plus or minus 1 SD and the number of patients studied at each location were: RVIT--normal 23 plus or minus 13 (15 patients); RVIT-RBBB 49 plus or minus 16 (15 patients); RVA--normal 18 plus or minus 9 (28 patients); RVA-RBBB 54 plus or minus 16 (30 patients); RVOT--normal 40 plus or minus 10 (28 patients); RVOT-RBBB 78 plus or minus 21 (30 patients);LVA--normal 9 plus or minus 9 (18 patients); LVA-RBBB 6 plus or minus 10 (10 patients); LVOT--normal 45 plus or minus 13 (10 patients); LVOT-RBBB 32 plus or minus 9 (7 patients). Significant differences observed were: RVA-normal versus RVA-RBBB P smaller than 0.001; RVOT-RBBB P smaller than 0.001; RVA-normal versus LVA-normal P smaller than 0.005; LVA-normal versus LVA-RBBB NS, LVOT-normal versus LVOT-RBBB P smaller than 0.05. The LVOT change was unexpected and suggests changes in left ventricular depolarization may occur when right bundle branch block develops. In patients with RBBB the activation of the RVA (r equals 0.82) and of the RVOT (r equals 0.68) was directly related to the duration of QRS. Changes in activation time when RBBB was induced by rapid atrial pacing or by introduction of atrial premature depolarizations were: RVA (7 patients) 19 plus or minus 11 to 56 plus or minus 16 (P smaller than 0.001); RVOT (9 patients) 41 plus or minus 10 to 77 plus or minus 22 (P SMALLER THAN 0.001); LVA (5 patients) and LVOT (2 patients), small insignigicant changes. These data indicate that endocardial activation changes can be evaluated in the catheterization laboratory, that right ventricular conduction becomes slower in RBBB as a direct function of total QRS and that left ventricular conduction may be affected when RBBB develops.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Trending Papers

Remove bar
Read by QxMD icon Read
1122581
×

Save your favorite articles in one place with a free QxMD account.

×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"