| Autor: |
Gonzalez, Rolando, Scheinman, Melvin, Thomas, Arthur, Desai, Jawahar, Peters, Robert, Dzindzio, Barry |
| Předmět: |
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| Zdroj: |
Pacing & Clinical Electrophysiology; Mar1981, Vol. 4 Issue 2, p152-162, 11p |
| Abstrakt: |
Seven patients who had His bundle section and permanent ventricular pacemaker insertion for intractable recurrent supraventricular tachycardia underwent electrophysiologic studies 4..6 months postoperatively. The permanent pacemaker was inhibited to assess the His bundle recovery time (HBRT) and spontaneous His bundle rate (SHBR) (tenth postinhibition cycle). In addition, in five of the seven patients, the HBBT and SHBR was also assessed during mild supine exercise and after administration of intravenous atropine followed by lidocaine. There was no significant difference in HBRT or SHBR before exercise (2695 ± 1056 ms; 1435 ± 75 ms), during mild supine exercise (2220 ± 1564 ms; 1379 ± 42 ms), or after atropine (2152 ± 544 ms; 1379 ± 117 ms) or lidocaine (3943 ± 3198; 1487 ± 139 ms, respectively). Only one patient showed consistent lengthening of both HBRT and SHBR after lidocaine. On a separate day, programmed ventricular extrastimuli were induced during ventricular overdrive pacing. In three of the seven patients, programmed ventricular extrastimuli resulted in typical bundle branch reentrant depolarizations. Four of the seven patients underwent maximal exercise treadmill testing. In none of these four patients did the His bundle rate exceed that of the implanted pacemaker. We conclude that prolonged pauses often follow pacemaker inhibition in these patients; therefore, careful follow-up of pacemaker function is required. Surgically induced His bundle rhythms in man are characterized by spontaneous rates of 38.7 to 45.5 beats/min and do not increase their rate after vagolysis or during mild exercise. In addition, the atrioventricular node is not required for bundle branch reentry in man. [ABSTRACT FROM AUTHOR] |
| Databáze: |
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