Reassessment of the Subdivision Block of the Left Bundle Branch : Cardiac Conduction Disturbances : Structure, Function and Clinical Significance
スポンサーリンク
概要
- 論文の詳細を見る
There still exist many questions to the human intraventricular conduction system, especially morphology of left ventricular (LV) conduction system. In the present study, LV conduction system was examined by serial histological examinations, and based on these results experimental and clinical subdivision block of the left bundle branch (LBB) were studied electrophysiologically and histopathologically. 1 ) Reconstruction of the human LBB: Human LV conduction system of 14 hearts showed much variability. LV conduction system was a diffuse fan like structure broadly distributed over the left septal surface and always covered diffusely mid-septal area. 2) Experimental subdivision block of the LBB: In the discrete block of the septal Purkinje network (11 dogs), the activation time in the apical area prolonged from 20.0±4.9 msec to 24.5±4.9 msec (p<0.05), and the QRS loop tended to be displaced anteriorly. In the discrete block of the left posterior division (9 dogs), the activation time showed slight prolongation in the posterior basal area, but the QRS waves of the scalar ECG did not change significantly. In the block of the left posterior division and septal Purkinje network ( 11 dogs), epicardial activation delay was observed in a relatively wider area from the apex to the posterior basal area. The maximum QRS vector in the frontal plane shifted rightward (p<0.05). 3) Prominent anterior QRS force (PAF) in clinical electrocardiogram: PAF was observed frequently in patients with ischemic heart disease (12.4%) and diabetes mellitus (8.5%). Serial histological examination of a patient with PAF showed marked fibrosis in the mid-septal fibers in association with fibrosis of the right bundle branch and posterior part of the LBB. Intermittent PAF was observed in supraventricular premature beats suggesting that PAF might be due to intraventricular conduction disturbances as well as left anterior or posterior hemiblock. This intermittency also supports the existence of this new type of divisional block of the LBB. New concepts of intraventricular conduction disturbances must be established including the conduction disturbances of the mid-septal fibers of the LV conduction system.
- 社団法人日本循環器学会の論文
- 1981-04-20
著者
-
Nakaya Yutaka
The Second Department of Internal Medicine, School of Medicine, The University of Tokushima
-
Hiraga Takashi
The Second Department Of Internal Medicine The University Of Tokushima
-
Hiraga Takashi
The Second Department Of Internal Medicine School Of Medicine Tokushima University
-
Nakaya Yutaka
The Second Department Of Internal Medicine The University Of Tokushima
関連論文
- INFLUENCES OF VERAPAMIL AND MAGNESIUM SULFATE ON ISCHMIC MYOCARDIUM BY CORONARY SINUS RETROPERFUSION : EFFECTS ON ELECTROPHYSIOLOGICAL CHANGES DURING ACUTE MYOCARDIAL ISCHEMIA AND AFTER REPERFUSION
- FREQUENCY-DEPENDENT EFFECT OF MS-551, MEXILETINE, AND THEIR COMBINATION ON VENTRICULAR REFRACTORINESS
- -1235-EFFECT OF ENDOTHELIN ON SINGLE K^+ CHANNEL CURRENTS OF CULTURED CORONARY ARTERY SMOOTH MUSCLE CELLS : THE 54th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- MAGNETOCARDIOGRAM IN MYOCARDIAL INFARCTION : PROCEEDINGS OF THE 47th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY : Electrocardiography
- -1091-THE EFFECTS OF NICORANDIL, SITS AND 4-AP ON SINGLE K^+ CHANNEL CURRENTS IN PORCINE CORONARY ARTERY SMOOTH MUSCLE CELLS : THE 54th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- -1070-EFFECT OF CLASS I ANTIARRHYTHMIC DRUGS ON REPOLARIZATION SLOPE AND PREMATURE ACTION POTENTIAL DURATION : THE 54th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- -0403-EFFECTS OF ISOPROTERENOL, MGSO_4 AND VERAPAMIL ON LONG-SHORT VENTRICULAR SEQUENCE AT THE BEGINNING OF TORSADE DE POINTES
- -0116-ELECTROPHYSIOLOGICAL STUDY OF ATRIOVENTRICULAR CONDUCTION SYSTEM IN ADULT ATRIAL SEPTAL DEFECT
- -525-FREE AND CONJUGATED DOPAMINE IN PATIENTS WITH CONGESTIVE HEART FAILURE : Heart Failure : FREE COMMUNICATIONS(II) : PROCEEDINGS OF THE 53th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- -52-DETECTION OF ACCESSORY PATHWAY IN PATIENTS WITH WPW SYNDROME : DIAGNOSIS OF THF, POSITION BY MEANS OF MAGNETOCARDIOGRAM AND GATED MRI : Arrhythmias : FREE COMMUNICATIONS(I) : PROCEEDINGS OF THE 53th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATIO
- VECTORCARDIOGRAPHIC AND EPICARDIAL ACTIVATION STUDERS ON EXPERIMENTALLY-INDUCED SUBDIVISION BLOCK OF THE LEFT BUNDLE BRANCH
- STUDIES ON T WAVES OF MAGNETOCARDIOGRAM IN ANGINA PECTORIS : Electrocardiography (III) : FREE COMMUNICATIONS (IV) : PROCEEDINGS OF THE 49th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY
- STUDY ON THE SPATIAL CIRCUMFERENCE ECG IN NORMAL P WAVE : Ist Auditorium : PROCEEDINGS OF THE 40TH ANNUAL MEETING OF THE JAPANESE CIRCULATION SOCIETY
- STUDIES ON THE MECHANISM OF REPERFUSION ARRHYTHMIA : Arrhythmias (II), Electrophysiology (II), Mapping : III : 48 Annual Scientific Meeting, Japanese Circulation Society
- -P248- LOOSE PATCH CLAMP IN VASCULAR SMOOTH MUSCLE
- Reassessment of the Subdivision Block of the Left Bundle Branch : Cardiac Conduction Disturbances : Structure, Function and Clinical Significance
- STUDY ON THE CHANGE OF U WAVES IN VARIOUS HEART DISEASES : Electrocardiography : FREE COMMUNICATIONS (Abstract) : 45 Annual Scientific Meeting, Japanese Circulation Society
- CLINICAL AND EXPERIMENTAL STUDIES OF THE DETERMINATION OF SERUM GUANASE ACTIVITY IN ACUTE MYOCARDIAL
- VECTORCARDIOGRAM OF PHYSIOLOGIC SUBDIVISION BLOCK OF THE LEFT BUNDLE BRANCH : The Fifth Conference on Vectorcardiography
- -1148-FREE AND CONJUGATED DOPAMINE IN PATIENTS WITH HEART FAILURE IN EACH CLASS OF NYHA CLACIFICATION OF CARDIAC PERFORMANCE : THE 54th ANNUAL SCIENTIFIC MEETING OF THE JAPANESE CIRCULATION SOCIETY