Waisser E, Gaasch W H, Quinones M A, Alexander J K
Eur J Cardiol. 1975 Jan;2(3):343-50.
His bundle electrograms were obtained at rest and during atrial pacing in 16 patients with congestive cardiomyopathy. Increments in heart rate during atrial pacing were associated with progressive increases in the A-H interval in all patients. Three patients had abnormal conduction (prolonged P-H) proximal to the His bundle; atrial pacing resulted in second degree A-V block (A-H block) in these three patients at paced rates below 130/min; these three patients were on digitalis at the time of the study. Two patients ahd left bundle branch block associated with a prolonged H-V interval suggesting a conduction disturbance in the contralateral bundle system either at or distal to the branching portion of the His bundle. Two patients had H-V prolongation in the presence of a normal QRS duration which suggests delay in the bundle of His. Two patients with normal H-V intervals had marked prolongation of the total intraventricular conduction time (H-S prolongation). The His bundle electrogram uncovered abnormalities in atrioventricular conduction not apparent on the standard electrocardiogram and has allowed expansion of our knowledge regarding the electrophysiologic features of congestive cardiomyopathy.
对16例充血性心肌病患者在静息状态下以及心房起搏时记录了希氏束电图。在所有患者中，心房起搏时心率增加与A-H间期逐渐延长相关。3例患者在希氏束近端存在传导异常（P-H间期延长）；在这3例患者中，心房起搏在起搏频率低于130次/分钟时导致二度房室传导阻滞（A-H阻滞）；这3例患者在研究时正在服用洋地黄。2例患者有左束支传导阻滞，伴有H-V间期延长，提示在希氏束分支部位或其远端的对侧束支系统存在传导障碍。2例患者在QRS时限正常的情况下出现H-V间期延长，提示希氏束延迟。2例H-V间期正常的患者出现总心室内传导时间明显延长（H-S延长）。希氏束电图揭示了标准心电图上不明显的房室传导异常，并扩展了我们对充血性心肌病电生理特征的认识。
