Molina L, Pinto R, Colín L, Buendía A
Arch Inst Cardiol Mex. 1983 Nov-Dec;53(6):489-95.
Atrioventricular (A-V) conduction was evaluated in 51 patients who underwent electro-physiological study. Eighteen patients had nodal conduction delay (A-H greater than 150 ms), six of them were congenital, in two others it was associated to a His-Purkinje (H-V) delay. None of them had bundle branch block in the surface ECG. The conduction delay was located within the his bundle in 15 patients (29.4%). In three of them, a split His bundle electrogram was recorded; in the other 12 (80%), His bundle stimulation normalized QRS morphology; in all of these patients H-V interval was longer than 70 ms. His bundle delay was associated to infra H lesion in five patients. In one without ECG changes, atrial and His bundle stimulation demonstrated a left troncular delay with a distal block in the right bundle branch. Thirteen patients had infra His block represented by a long H-V interval (greater than 60 ms). We conclude that His bundle electrograms and stimulation is a low risk procedure very useful in the topographic diagnosis of A-V conduction disturbances.
对51例接受电生理研究的患者进行了房室（A-V）传导评估。18例患者存在结性传导延迟（A-H大于150毫秒），其中6例为先天性，另外2例与希氏束-浦肯野（H-V）延迟有关。他们在体表心电图中均无束支传导阻滞。15例患者（29.4%）的传导延迟位于希氏束内。其中3例记录到分裂的希氏束电图；另外12例（80%）中，希氏束刺激使QRS形态正常化；所有这些患者的H-V间期均长于70毫秒。希氏束延迟与5例患者的希氏束以下病变有关。在1例无心电图改变的患者中，心房和希氏束刺激显示左束支延迟伴右束支远端阻滞。13例患者存在以长H-V间期（大于60毫秒）为表现的希氏束以下阻滞。我们得出结论，希氏束电图和刺激是一种低风险的检查方法，对房室传导障碍的定位诊断非常有用。
