Bifascicular block: Difference between revisions
Jump to navigation
Jump to search
Hardik Patel (talk | contribs) (/* Permanent Pacing in Chronic Bifascicular Block Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, S...) |
Hardik Patel (talk | contribs) (/* Permanent Pacing in Chronic Bifascicular Block Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, S...) |
||
| Line 28: | Line 28: | ||
==2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (DO NOT EDIT)<ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>== | ==2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (DO NOT EDIT)<ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>== | ||
===Permanent Pacing in Chronic Bifascicular Block<ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>=== | ===Permanent Pacing in Chronic Bifascicular Block (DO NOT EDIT)<ref name="Epstein"> Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207 </ref>=== | ||
{|class="wikitable" | {|class="wikitable" | ||
|- | |- | ||
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | | colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]] | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation is indicated for advanced [[second-degree AV block]] or intermittent [[third-degree AV block]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation is indicated for advanced [[second-degree AV block]] or intermittent [[third-degree AV block]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<ref name="pmid14206803">{{cite journal| author=FRIEDBERG CK, DONOSO E, STEIN WG| title=NONSURGICAL ACQUIRED HEART BLOCK. | journal=Ann N Y Acad Sci | year= 1964 | volume= 111 | issue= | pages= 835-47 | pmid=14206803 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14206803 }} </ref><ref name="pmid1883673">{{cite journal| author=| title=Recommendations for pacemaker prescription for symptomatic bradycardia. Report of a working party of the British Pacing and Electrophysiology Group. | journal=Br Heart J | year= 1991 | volume= 66 | issue= 2 | pages= 185-91 | pmid=1883673 | doi= | pmc=PMC1024617 | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=1883673 }} </ref><ref name="pmid14149997">{{cite journal| author=GADBOYS HL, WISOFF G, LITWAK RS| title=SURGICAL TREATMENT OF COMPLETE HEART BLOCK. AN ANALYSIS OF 36 CASES. | journal=JAMA | year= 1964 | volume= 189 | issue= | pages= 97-102 | pmid=14149997 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14149997 }} </ref><ref name="pmid5223645">{{cite journal| author=Johansson BW| title=Complete heart block. A clinical, hemodynamic and pharmacological study in patients with and without an artificial pacemaker. | journal=Acta Med Scand Suppl | year= 1966 | volume= 451 | issue= | pages= 1-127 | pmid=5223645 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5223645 }} </ref><ref name="pmid688580">{{cite journal| author=Hindman MC, Wagner GS, JaRo M, Atkins JM, Scheinman MM, DeSanctis RW et al.| title=The clinical significance of bundle branch block complicating acute myocardial infarction. 2. Indications for temporary and permanent pacemaker insertion. | journal=Circulation | year= 1978 | volume= 58 | issue= 4 | pages= 689-99 | pmid=688580 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=688580 }} </ref><ref name="pmid4951735">{{cite journal| author=Donmoyer TL, DeSanctis RW, Austen WG| title=Experience with implantable pacemakers using myocardial electrodes in the management of heart block. | journal=Ann Thorac Surg | year= 1967 | volume= 3 | issue= 3 | pages= 218-27 | pmid=4951735 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4951735 }} </ref><ref name="pmid13356435">{{cite journal| author=LEVINE SA, MILLER H, PENTON GB| title=Some clinical features of complete heart block. | journal=Circulation | year= 1956 | volume= 13 | issue= 6 | pages= 801-24 | pmid=13356435 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=13356435 }} </ref><nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Permanent [[pacemaker]] implantation is indicated for type II [[second-degree AV block]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' Permanent [[pacemaker]] implantation is indicated for type II [[second-degree AV block]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<ref name="pmid4817704">{{cite journal| author=Dhingra RC, Denes P, Wu D, Chuquimia R, Rosen KM| title=The significance of second degree atrioventricular block and bundle branch block. Observations regarding site and type of block. | journal=Circulation | year= 1974 | volume= 49 | issue= 4 | pages= 638-46 | pmid=4817704 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4817704 }} </ref><ref name="pmid14118480">{{cite journal| author=DONOSO E, ADLER LN, FRIEDBERG CK| title=UNUSUAL FORMS OF SECOND-DEGREE ATRIOVENTRICULAR BLOCK, INCLUDING MOBITZ TYPE-II BLOCK, ASSOCIATED WITH THE MORGAGNI-ADAMS-STOKES SYNDROME. | journal=Am Heart J | year= 1964 | volume= 67 | issue= | pages= 150-7 | pmid=14118480 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14118480 }} </ref><ref name="pmid5009474">{{cite journal| author=Ranganathan N, Dhurandhar R, Phillips JH, Wigle ED| title=His Bundle electrogram in bundle-branch block. | journal=Circulation | year= 1972 | volume= 45 | issue= 2 | pages= 282-94 | pmid=5009474 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5009474 }} </ref><ref name="pmid4854561">{{cite journal| author=Dhingra RC, Denes P, Wu D, Chuquimia R, Amat-y-Leon F, Wyndham C et al.| title=Syncope in patients with chronic bifascicular block. Significance, causative mechanisms, and clinical implications. | journal=Ann Intern Med | year= 1974 | volume= 81 | issue= 3 | pages= 302-6 | pmid=4854561 | doi= | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=4854561 }} </ref><nowiki>"</nowiki> | ||
|- | |- | ||
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Permanent [[pacemaker]] implantation is indicated for alternating [[bundle-branch block]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | | bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Permanent [[pacemaker]] implantation is indicated for alternating [[bundle-branch block]]. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
| Line 44: | Line 44: | ||
|colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit) | |colspan="1" style="text-align:center; background:LightCoral"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class III]] (No Benefit) | ||
|- | |- | ||
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation is not indicated for [[fascicular block]] without [[AV block]] or symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | |bgcolor="LightCoral"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation is not indicated for [[fascicular block]] without [[AV block]] or symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' Permanent [[pacemaker]] implantation is not indicated for [[fascicular block]] with [[first-degree AV block]] without symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | |bgcolor="LightCoral"|<nowiki>"</nowiki>'''2.''' Permanent [[pacemaker]] implantation is not indicated for [[fascicular block]] with [[first-degree AV block]] without symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|} | |} | ||
| Line 53: | Line 53: | ||
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation is reasonable for [[syncope]] not demonstrated to be due to [[AV block]] when other likely causes have been excluded, specifically [[ventricular tachycardia]] ([[VT]]). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation is reasonable for [[syncope]] not demonstrated to be due to [[AV block]] when other likely causes have been excluded, specifically [[ventricular tachycardia]] ([[VT]]). ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Permanent [[pacemaker]] implantation is reasonable for an incidental finding at electrophysiological study of a markedly prolonged HV interval (greater than or equal to 100 milliseconds) in asymptomatic patients. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''2.''' Permanent [[pacemaker]] implantation is reasonable for an incidental finding at electrophysiological study of a markedly prolonged HV interval (greater than or equal to 100 milliseconds) in asymptomatic patients. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' Permanent [[pacemaker]] implantation is reasonable for an incidental finding at electrophysiological study of pacing-induced infra-His block that is not physiological. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''3.''' Permanent [[pacemaker]] implantation is reasonable for an incidental finding at electrophysiological study of pacing-induced infra-His block that is not physiological. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki> | ||
|} | |} | ||
| Line 64: | Line 64: | ||
| colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | | colspan="1" style="text-align:center; background:LemonChiffon"| [[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIb]] | ||
|- | |- | ||
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation may be considered in the setting of [[neuromuscular disease]]s such as [[myotonic muscular dystrophy]], [[Erb dystrophy]] ([[limb-girdle muscular dystrophy]]), and [[peroneal muscular atrophy]] with [[bifascicular block]] or any [[fascicular block]], with or without symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki> | |bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' Permanent [[pacemaker]] implantation may be considered in the setting of [[neuromuscular disease]]s such as [[myotonic muscular dystrophy]], [[Erb dystrophy]] ([[limb-girdle muscular dystrophy]]), and [[peroneal muscular atrophy]] with [[bifascicular block]] or any [[fascicular block]], with or without symptoms. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])''<nowiki>"</nowiki> | ||
|} | |} | ||
Revision as of 17:38, 5 November 2012
| Bifascicular block | |
 | |
|---|---|
| ICD-10 | I45.2 |
| ICD-9 | 426.53 |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Overview
Bifascicular block is a conduction abnormality in the heart where two of the three main fascicles of the His/Purkinje system are blocked.
Most commonly, it refers to a combination of right bundle branch block (RBBB) and either left anterior fascicular block (LAFB) or left posterior fascicular block (LPFB).
Some authors consider left bundle branch block (LBBB) to be a technical bifascicular block, since the block occurs above the bifurcation of the left anterior and left posterior fascicles of the left bundle branch.
Electrocardiogram
2008 ACC/AHA/HRS Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities (DO NOT EDIT)[1]
Permanent Pacing in Chronic Bifascicular Block (DO NOT EDIT)[1]
| Class I |
| "1. Permanent pacemaker implantation is indicated for advanced second-degree AV block or intermittent third-degree AV block. (Level of Evidence: B)[2][3][4][5][6][7][8]" |
| "2. Permanent pacemaker implantation is indicated for type II second-degree AV block. (Level of Evidence: B)[9][10][11][12]" |
| "3. Permanent pacemaker implantation is indicated for alternating bundle-branch block. (Level of Evidence: C)" |
| Class III (No Benefit) |
| "1. Permanent pacemaker implantation is not indicated for fascicular block without AV block or symptoms. (Level of Evidence: B)" |
| "2. Permanent pacemaker implantation is not indicated for fascicular block with first-degree AV block without symptoms. (Level of Evidence: B)" |
| Class IIa |
| "1. Permanent pacemaker implantation is reasonable for syncope not demonstrated to be due to AV block when other likely causes have been excluded, specifically ventricular tachycardia (VT). (Level of Evidence: B)" |
| "2. Permanent pacemaker implantation is reasonable for an incidental finding at electrophysiological study of a markedly prolonged HV interval (greater than or equal to 100 milliseconds) in asymptomatic patients. (Level of Evidence: B)" |
| "3. Permanent pacemaker implantation is reasonable for an incidental finding at electrophysiological study of pacing-induced infra-His block that is not physiological. (Level of Evidence: B)" |
| Class IIb |
| "1. Permanent pacemaker implantation may be considered in the setting of neuromuscular diseases such as myotonic muscular dystrophy, Erb dystrophy (limb-girdle muscular dystrophy), and peroneal muscular atrophy with bifascicular block or any fascicular block, with or without symptoms. (Level of Evidence: C)" |
External Links
Additional Reading
- Moss and Adams' Heart Disease in Infants, Children, and Adolescents Hugh D. Allen, Arthur J. Moss, David J. Driscoll, Forrest H. Adams, Timothy F. Feltes, Robert E. Shaddy, 2007 ISBN 0781786843
- Braunwald's Heart Disease, Libby P, 8th ed., 2007, ISBN 978-1-41-604105-4
- Hurst's the Heart, Fuster V, 12th ed. 2008, ISBN 978-0-07-149928-6
- Willerson JT, Cardiovascular Medicine, 3rd ed., 2007, ISBN 978-1-84628-188-4
Sources
- The ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities [1]
References
- ↑ 1.0 1.1 1.2 Epstein AE, DiMarco JP, Ellenbogen KA, Estes NAM III, Freedman RA, Gettes LS, Gillinov AM, Gregoratos G, Hammill SC, Hayes DL, Hlatky MA, Newby LK, Page RL, Schoenfeld MH, Silka MJ, Stevenson LW, Sweeney MO. ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities: executive summary: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the ACC/AHA/NASPE 2002 Guideline Update for Implantation of Cardiac Pacemakers and Antiarrhythmia Devices). Circulation. 2008; 117: 2820–2840. PMID 18483207
- ↑ FRIEDBERG CK, DONOSO E, STEIN WG (1964). "NONSURGICAL ACQUIRED HEART BLOCK". Ann N Y Acad Sci. 111: 835–47. PMID 14206803.
- ↑ "Recommendations for pacemaker prescription for symptomatic bradycardia. Report of a working party of the British Pacing and Electrophysiology Group". Br Heart J. 66 (2): 185–91. 1991. PMC 1024617. PMID 1883673.
- ↑ GADBOYS HL, WISOFF G, LITWAK RS (1964). "SURGICAL TREATMENT OF COMPLETE HEART BLOCK. AN ANALYSIS OF 36 CASES". JAMA. 189: 97–102. PMID 14149997.
- ↑ Johansson BW (1966). "Complete heart block. A clinical, hemodynamic and pharmacological study in patients with and without an artificial pacemaker". Acta Med Scand Suppl. 451: 1–127. PMID 5223645.
- ↑ Hindman MC, Wagner GS, JaRo M, Atkins JM, Scheinman MM, DeSanctis RW; et al. (1978). "The clinical significance of bundle branch block complicating acute myocardial infarction. 2. Indications for temporary and permanent pacemaker insertion". Circulation. 58 (4): 689–99. PMID 688580.
- ↑ Donmoyer TL, DeSanctis RW, Austen WG (1967). "Experience with implantable pacemakers using myocardial electrodes in the management of heart block". Ann Thorac Surg. 3 (3): 218–27. PMID 4951735.
- ↑ LEVINE SA, MILLER H, PENTON GB (1956). "Some clinical features of complete heart block". Circulation. 13 (6): 801–24. PMID 13356435.
- ↑ Dhingra RC, Denes P, Wu D, Chuquimia R, Rosen KM (1974). "The significance of second degree atrioventricular block and bundle branch block. Observations regarding site and type of block". Circulation. 49 (4): 638–46. PMID 4817704.
- ↑ DONOSO E, ADLER LN, FRIEDBERG CK (1964). "UNUSUAL FORMS OF SECOND-DEGREE ATRIOVENTRICULAR BLOCK, INCLUDING MOBITZ TYPE-II BLOCK, ASSOCIATED WITH THE MORGAGNI-ADAMS-STOKES SYNDROME". Am Heart J. 67: 150–7. PMID 14118480.
- ↑ Ranganathan N, Dhurandhar R, Phillips JH, Wigle ED (1972). "His Bundle electrogram in bundle-branch block". Circulation. 45 (2): 282–94. PMID 5009474.
- ↑ Dhingra RC, Denes P, Wu D, Chuquimia R, Amat-y-Leon F, Wyndham C; et al. (1974). "Syncope in patients with chronic bifascicular block. Significance, causative mechanisms, and clinical implications". Ann Intern Med. 81 (3): 302–6. PMID 4854561.