His bundle electrograms were recorded and A-V junction pacing was achieved in 30 patients by a pervenous electrode catheter technic. His bundle pacing was achieved in 26, and A-V node pacing in five patients. Conduction time from atrium to the His bundle (A-H time) and His bundle to ventricular activation (H-V time) were measured. During His bundle pacing, the pacing impulse to ventricular acti...

It has been demonstrated that catheter ablation may be a reliable technique for curing ventricular arrhythmias originating from the great cardiac vein (GCV), and there are some challenges and risks with this therapeutic method. Although some reports described successful catheter ablation of ventricular tachycardias originating from the GCV, premature ventricular contractions (PVCs) with left bu...

Traditional right ventricular pacing prolongs the electrical and mechanical activation of the heart, which reduces the pump function, and in selected patients may lead to pacing-induced heart failure. Pacing the His bundle preserves the normal or near-normal activation pattern of the ventricles that prevents the detrimental effects of right ventricular pacing. This review discusses the techniqu...

The exact prevalence and nature of cardiac involvement in facioscapulohumeral muscular dystrophy (FSHD) is unknown. Nevertheless, the current opinion is that symptomatic cardiac disease is rare. We performed a cardiac screening [electrocardiogram (ECG) and echocardiography in the event of ECG abnormalities] in 75 genetically confirmed, ambulant FSHD patients without cardiac symptoms, with an ei...

Routes of impulse propagation during reentry in the His-Purkinje system (Re-HPS) in 13 patients were studied using the right ventricular extra stimulus (V2) method and right bundle branch (RBB) recordings in addition to the conventional His (H) bundle recordings. The H-V and RB-V intervals during sinus rhythm averaged 44.2 and 27.6 msec respectively, with the average antegrade H-RB interval 16....

Biventricular pacing has been used to treat patients with symptomatic heart failure, systolic left ventricular dysfunction and intraventricular conduction delays. This modality is usually reserved for the treatment of patients with a left bundle branch block pattern on electrocardiogram. We report the successful use of biventricular pacing in a patient with heart failure and a right bundle bran...

Four patients with paroxysmal supraventricular tachycardia have been studied using programmed electrical stimulation of the heart and intracardiae recordings. One patient had an atrioventricular (A-V) junctional tachycardia, possibly due to a rapidly discharging protected ectopic focus, and three patients had anomalous atrioventricular connections. The ECG recordings in all four patients showed...

A 29-year-old female with Uhl's anomaly developed complete atrioventricular (A-V) block. His bundle studies revealed block distal to the His bundle recording site with narrow QRS complexes. Right ventricular capture could not be obtained and despite successful left ventricular epicardial pacing, the patient died. Autopsy revealed absence of myocardium in most areas of the right ventricle and th...

Bundle branch block is a common cause of a widened QRS complex, and, as indicated in Table 1, different mechanisms may be responsible. Three are rate related and one is based upon retrograde invasion into the bundle branch. Those four mechanisms lead to the intermittent appearance of a bundle branch block pattern. Most commonly, bundle branch block is continuously present, so-called fixed bundl...