Sung R J, Tamer D M, Garcia O L, Castellanos A, Myerburg R J, Gelband H
Circulation. 1976 Sep;54(3):442-6. doi: 10.1161/01.cir.54.3.442.
Using intracardiac recording techniques, His bundle (H) and right ventricular apical (RVA) electrograms were recorded in 16 patients with a postoperative electrocardiographic pattern of right bundle branch block (RBBB). Their ages ranged from 5 to 12 years (mean 6.9 years) at surgery and the follow-up period was 1 to 7 years (mean 2.7 years). All were asymptomatic and in sinus rhythm at the time of study. The P-A interval was normal in all and the A-H, H-V, and V-RVA intervals were prolonged in one, one, and six patients, respectively. The V-RNA interval was normal (less than or equal to 30 msec) in ten out of the 11 patients (91%) without associated left anterior hemiblock (LAH), indicating a physiologically intact main right bundle branch, and was abnormally lengthened (45-62 msec) in all five patients (100%) with associated LAH. These findings suggest that there are two subgroups of patients with surgicall-induced RBBB pattern and the measurement of the V-RVA interval in conjunction with the H-V interval may be of ultimate importance in understanding the long-term prognostic implication of surgically-induced RBBB pattern with or without LAH.
采用心内记录技术，对16例术后心电图呈现右束支传导阻滞（RBBB）图形的患者记录希氏束（H）电图和右心室心尖部（RVA）电图。手术时他们的年龄在5至12岁之间（平均6.9岁），随访期为1至7年（平均2.7年）。研究时所有患者均无症状且为窦性心律。所有患者的P-A间期均正常，A-H、H-V和V-RVA间期分别在1例、1例和6例患者中延长。11例无合并左前分支阻滞（LAH）的患者中有10例（91%）的V-RNA间期正常（小于或等于30毫秒），表明右束支主干生理功能完整，而5例合并LAH的患者V-RVA间期均异常延长（45 - 62毫秒）（100%）。这些发现提示，手术诱发RBBB图形的患者存在两个亚组，V-RVA间期与H-V间期联合测量对于理解手术诱发RBBB图形伴或不伴LAH的长期预后意义可能至关重要。
