Khalilullah M, Singhal N, Gupta U, Padmavati S
Am Heart J. 1979 May;97(5):608-12. doi: 10.1016/0002-8703(79)90188-1.
Forty-two patients with complete heart block were subjected to electrophysiological studies wherein apart from localization of the site of the conduction defect, ventricular pacing was done to assess ventriculo-atrial (VA) conduction and concealed ventriculo-nodal (VN) conduction. There was evidence of retrograde conduction in the presence of orthograde CHB in 22 patients (52.4 per cent). Fifteen patients (35.7 per cent) had VA conduction and seven (16.6 per cent) had concealed VN conduction. In patients with supra-Hisian CHB, three of the nine patients had VA conduction while of the 11 patients with intra-Hisian CHB, six had retrograde conduction (four with VA and two with concealed VN conduction). In the infra-Hisian CHB group, of the 22 patients, eight had VA conduction and five had concealed conduction. Incremental ventricular pacing induced VA Wenckebach periods at VPR from 110 to 133/minute with a VA interval of 110 to 130 msec. In view of the induction of Wenckebach VA periods, the recording of retrograde H potentials in some cases, and relatively long VA conduction time, it is surmised that retrograde conduction in the presence of orthograde CHB takes place through the AV conduction system.
42例完全性心脏传导阻滞患者接受了电生理研究，除了定位传导缺陷部位外，还进行了心室起搏以评估室房（VA）传导和隐匿性室结（VN）传导。22例患者（52.4%）在存在顺行性完全性心脏传导阻滞时存在逆行传导证据。15例患者（35.7%）有VA传导，7例（16.6%）有隐匿性VN传导。在希氏束以上完全性心脏传导阻滞患者中，9例中有3例有VA传导，而在希氏束内完全性心脏传导阻滞的11例患者中，6例有逆行传导（4例有VA传导，2例有隐匿性VN传导）。在希氏束以下完全性心脏传导阻滞组中，22例患者中有8例有VA传导，5例有隐匿性传导。递增性心室起搏在心室起搏率为110至133次/分钟时诱发VA文氏周期，VA间期为110至130毫秒。鉴于诱发了文氏VA周期，在某些情况下记录到逆行H电位，以及相对较长的VA传导时间，推测在顺行性完全性心脏传导阻滞存在时的逆行传导是通过房室传导系统发生的。
