Intraventricular Delay and Blocks

Fabio M Leonelli; Giuseppe Bagliani; Roberto De Ponti; Luigi Padeletti

doi:10.1016/j.ccep.2018.02.003

Intraventricular Delay and Blocks

Card Electrophysiol Clin. 2018 Jun;10(2):211-231. doi: 10.1016/j.ccep.2018.02.003.

Authors

Fabio M Leonelli¹, Giuseppe Bagliani², Roberto De Ponti³, Luigi Padeletti⁴

Affiliations

¹ Cardiology Department, James A. Haley Veterans' Hospital, University of South Florida, Tampa, FL, USA. Electronic address: fabio.leonelli@va.gov.
² Cardiology Department, Arrhythmology Unit, Foligno General Hospital, Foligno, Italy; Cardiovascular Diseases Department, University of Perugia, Perugia, Italy.
³ Cardiology Department, University of Insubria, Varese, Italy.
⁴ Heart and Vessels Department, University of Florence, Florence, Italy; IRCCS Multimedica, Sesto San Giovanni, Italy.

PMID: 29784481
DOI: 10.1016/j.ccep.2018.02.003

Abstract

From the atrioventricular node, electrical activation is propagated to both ventricles by a system of specialized conducting fibers, His Purkinje System (HPS), guaranteeing a fast, synchronous depolarization of both ventricles. From the predivisional common stem, a right and left branch separate, subdividing further in a fairly predictable fashion. Synchronous ventricular activation results in a QRS with specific characteristics and duration of less than 110 milliseconds. Block or delay in any part of the HPS changes the electrocardiographic (ECG) morphology. This article discusses the use and limitations of standard ECG in detecting abnormal ventricular propagation in specific areas of the HPS.

Keywords: Bundle branch block; Hemiblocks; His Purkinje disease; Left bundle branch; Right bundle branch block.

Publication types

Review

MeSH terms

Bundle of His / physiopathology*
Bundle-Branch Block / diagnosis
Bundle-Branch Block / physiopathology*
Electrocardiography*
Heart Ventricles / physiopathology*
Humans