Guimond C, Puech P
Eur J Cardiol. 1976 Dec;4(4):481-93.
Some intra-His bundle (intra-HB) blocks escape the routine exploration of the His bundle and are confused with supra- or infrahisian blocks. We believe that a more accurate exploration (recording of His bundle activity successively at the proximal end and the distal end of the His bundle, dynamic tests and drug injection) is needed to detect some concealed cases, mostly paroxysmal intra-HB blocks. In this series of 102 cases of intra-HB blocks, 20% had no criteria of AV block on the surface electrocardiogram, and only 4% had an intact conduction pattern (normal PR interval and normal QRS complexes.) A first degree intra-HB block was found in 35% (15 cases with a normal PR interval), a second degree intra-HB block in 23% and a thired degree intra-HB block in 42% of the cases (unidirectional in 4 cases). Of the 43% having an isolated intra-HB block, most were elderly women with a chronic third degree AV block.
一些希氏束内（HB内）阻滞难以通过常规的希氏束探查被发现，常与希氏束上或希氏束下阻滞相混淆。我们认为，需要更精确的探查（在希氏束近端和远端连续记录希氏束活动、进行动态试验及药物注射）来检测一些隐匿性病例，尤其是阵发性HB内阻滞。在这102例HB内阻滞病例中，20%的患者体表心电图无房室阻滞标准，仅有4%的患者传导模式正常（PR间期正常且QRS波群正常）。35%（15例PR间期正常）的病例发现有一度HB内阻滞，23%的病例有二度HB内阻滞，42%的病例有三度HB内阻滞（4例为单向阻滞）。在43%的孤立性HB内阻滞患者中，大多数为患有慢性三度房室阻滞的老年女性。
