Nakaya Y, Inoue H, Hiasa Y, Niki T, Mori H
Jpn Heart J. 1981 May;22(3):363-76. doi: 10.1536/ihj.22.363.
Changes of the activation sequence and vectorcardiogram (VCG) resulting from experimental block of specific sites of the left bundle branch were studied to determine the functional significance of the septal Purkinje network. Discrete block of the septal Purkinje network (11 dogs) resulted in slight delay of epicardial activation in the apical area. In lead Z of McFee system of VCG, the antero-posterior ratio was increased from 1.4 to 2.6, and the QRS loop tended to be displaced anteriorly. Discrete block of the left posterior division (9 dogs) resulted in slight delay of activation in the posterior basal area. Block of the left posterior division plus the septal Purkinje network (11 dogs) resulted in marked delay in activation of a wider area extending from the posterior basal area to the apical area. In lead X, the S wave became evident and the direction of the maximum QRS vector in the frontal plane showed significant right axis deviation. Discrete block of the left posterior division did not change the epicardial activation sequence or the direction of the maximum QRS vector, because there is extensive interconnection of the left ventricular conduction system. These results suggest that block of the septal Purkinje network itself may produce an electrocardiographic change and that this network may also be important in left anterior and posterior hemiblocks producing axis changes in the frontal plane of VCG.
研究了左束支特定部位实验性阻滞导致的激动顺序和向量心电图（VCG）变化，以确定间隔浦肯野网络的功能意义。间隔浦肯野网络的离散性阻滞（11只犬）导致心尖区心外膜激动稍有延迟。在VCG的McFee系统的Z导联中，前后比率从1.4增加到2.6，并且QRS环倾向于向前移位。左后分支的离散性阻滞（9只犬）导致后基底区激动稍有延迟。左后分支加间隔浦肯野网络的阻滞（11只犬）导致从后基底区到心尖区的更广泛区域的激动明显延迟。在X导联中，S波变得明显，额面最大QRS向量方向显示显著的电轴右偏。左后分支的离散性阻滞未改变心外膜激动顺序或最大QRS向量方向，因为左心室传导系统存在广泛的相互连接。这些结果表明，间隔浦肯野网络本身的阻滞可能产生心电图变化，并且该网络在导致VCG额面电轴变化的左前和左后半阻滞中也可能很重要。
