The Association of Complete Heart Block and Adams-Stokes Syndrome in Two Cases of Mobitz Type of Block

Kaufman, Jerome G.; Wachtel, Fred W.; Rothfield, Edwin; Bernstein, Arthur

doi:10.1161/01.cir.23.2.253

Cited by 27 publications

(1 citation statement)

References 2 publications

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“…In no patient in this series was a Mobitz type I block (with Wenkebach periods) found. This is in agreement with previous reports that type I A-V block is rare in cases of Adams-Stokes disease and that type II A-V block is commonly found before complete A-V block (Gilchrist, 1958;Kaufman et al, 1961;Donoso, Adler, and Friedberg, 1964;Langendorf and Pick, 1964). In the third stage, both bundle-branches were blocked and the ventricles were driven by a subsidiary ventricular pacemaker.…”

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confidence: 93%

Electrocardiographic findings in patients with complete atrioventricular block.

Lopez¹

1968

Heart

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The introduction of the artificial electrical pacemaker for the treatment of patients with complete A-V block has been accompanied by renewed interest in the pathogenesis of this disorder. It has been considered that most cases of complete block are due to organic or functional lesions either in the A-V node or in the common A-V bundle. Barker conduction through both bundle-branches was unequally impaired. In both of these situations, one would observe a complete right or left bundlebranch block with prolongation of the P-R interval.Complete block would be the manifestation of failure of conduction through the more depressed branch, while prolongation of the P-R interval would be the manifestation of depressed conduction through the less impaired branch. They stressed that true bilateral bundle-branch block must show a prolonged A-V conduction time. Mahaim (1931), and more recently Lenegre and Moreau (1962), and Lenegre (1964), have conducted pathological studies in the hearts of patients who had complete A-V block. They confirmed the electrocardiographic impression that in the great majority of patients this type of block was due to an anatomical bilateral bundle-branch block.To elucidate further the relation between bilateral bundle-branch block and A-V block, we have analysed the records of all patients with complete A-V block admitted to the University Hospital, Saskatoon, in the five-year period between 1960 and 1965. Patients with surgical A-V block and those in whom the history and clinical diagnosis suggested digitalis toxicity were excluded. The results of our study form the basis of this communication.SUBJECTS AND RESULTS Between 1960 and 1965, 57 patients with an electrocardiographic diagnosis of complete A-V block were studied at the University Hospital. In many instances previous electrocardiograms were available. The age of the patient, the clinical history, and electrical axis in the frontal plane were carefully recorded.The 57 patients were divided into two main groups, according to the contour of the ventricular complexes during the periods of complete A-V

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confidence: 93%