A correlation study between his bundle electrogram and histologic findings of the conduction system in various degrees of atrioventricular block.

Radiofrequency catheter ablation of the atrioventricular (AV) node or bundle of His was performed in 12 adult mongrel dogs. The aim was to create chronic incomplete AV block (first‐ and second‐degree AV block) and to examine the histopathology of the ablated lesions. However, the late electrophysiological results (2 4 weeks follow up) were various: normal in 2 dogs, mild PR prolongation (< 50%) in 2 dogs, first‐degree AV block (PR prolongation a 50%) in 2 dogs, second degree AV block in 2 dogs, complete AV block in 4 dogs. The maximally ablated area (%) of the atrioventricular conduction system in serial histologic sections from dogs with these conditions was 69%, 75%, 89.5%, 95% and 99.5%, respectively. The number of intact conduction cells at the maximally ablated site varied from 6 to 30 in the four cases of incomplete AV block. The mean ablated volume (%) of either the AV node or penetrating His bundle correlated roughly with the degree of AV block. The ablated lesions were well demarcated and almost replaced by dense fibrous tissue at 4 weeks. Interruption (3 dogs) or thinning (1 dog) of the endocardial elastic lamellae was detected, in association with endocardial thickening (mean 913 μm). Endocardial thrombi were found in 3 dogs (2 fresh, 1 organized). We conclude that radiofrequency catheter ablation does not cause severe complicated lesions. Several possible conditions for creating chronic incomplete AV block are discussed. Acta Pathol Jpn 41: 487–498, 1991.

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Pathological Aspects of Radiofrequency Catheter Ablation of the Canine Atrioventricular Node and Bundle of His

Tanaka

Satake

Kawahara

et al. 1991

Acta Pathologica Japonica

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A Clinico-pathological Analysis of Chronic Atrioventricular Block

Hiromoto

Inoue

Oki

et al. 1994

The Showa University Journal of Medical Sciences

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Hideaki TACHIBANA2), Youichi KOBAYASHI2) and Takashi KATAGIRI2Ã bstract: A histopathologic study based on serial sections of the conduction system was performed on 31 cases with chronic advanced or complete atrioventricular (AV) block. The patients were divided into 3 groups according to the injured portion of the conduction system: group 1 with lesions in the AV node or its approach, 4 patients; group 2 with lesions in His bundle, 10 patients; and group 3 with lesions of bundle branches and/or His bundle, 17 patients. The frequency of lesion site agreed with other reports. Fibrosis of the conduction system has been reported as the cause of conduction disturbance, but the etiology has not been made clear. In group 1, peri-cardial inflammation was seen in 3 of 4 cases. In group 2, inflammatory infiltration was noted in only 2 cases. Idiopathic fibrosis of conduction tissue or calcification of the AV ring was evident in 6 of 10 cases. In group 3, not only Lev disease and Lenegre disease but also perimyocarditis and its sequela were seen. Perimyocarditis and its sequela could be observed in 9 of 17 cases. Therefore, the occurrence ratio of perimyocarditis was higher than anticipated.

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A correlation study between his bundle electrogram and histologic findings of the conduction system in various degrees of atrioventricular block.

Cited by 2 publications

References 16 publications

Pathological Aspects of Radiofrequency Catheter Ablation of the Canine Atrioventricular Node and Bundle of His

Pathological Aspects of Radiofrequency Catheter Ablation of the Canine Atrioventricular Node and Bundle of His

A Clinico-pathological Analysis of Chronic Atrioventricular Block

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