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Cited by 249Cardiac pacing and defibrillation studiesCardiac electrophysiology and arrhythmiasCardiac Arrhythmias and Treatments

Value of the H-Q interval in patients with bundle branch block and the role of prophylactic permanent pacing

Scheinman, Melvin M., Peters, Robert W., Sauvé, Mary Jane, Desai, Jawahar, Abbott, Joseph A., Cogan, John, Wohl, Barry, Williams, Katherine·1982·The American Journal of Cardiology
DOI 10.1016/0002-9149(82)90469-6
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Abstract

His bundle electrograms were obtained in 313 patients with chronic bundle branch block who were followed for a mean period of almost 3 years. The infranodal conduction time (H-Q interval) was less than 55 ms in 97 patients (Group I), 55 to 69 ms in 99 patients (Group II), and greater than or equal to 70 ms in 117 patients (Group III). There was a higher incidence of organic heart disease in patients in Group III, but the groups were otherwise comparable. On follow-up study, mortality and the incidence of sudden death were similar among the groups, but patients in Group III had a greater incidence of progression to high degree atrioventricular block (HDB) than did those in Groups I and II (14 of 117 [12%] versus 4 of 97 [4%] and 2 of 99 [2%], p less than 0.01, respectively). High degree block was found in 4 of 17 (24%) patients with an H-Q interval (H-Q) greater than or equal to 100 ms. Sixty-two patients underwent permanent prophylactic pacemaker insertion at the discretion of the referring physician and were compared with 231 patients who did not. Paced patients had a higher incidence of transient neurologic symptoms and prolonged H-Q, but the groups were otherwise comparable. On follow-up study, mortality and the incidence of sudden death were similar among the groups, but symptom relief was significantly more common among patients with pacemakers. In conclusion, in our population (1) H-Q greater than or equal to 70 ms was an independent risk factor for progression to HDB,…

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  • The sensitivity and specificity of EPS to assess sinus node dysfunction and AV conduction disease in patients with syncope are variable, depending on patient selection and pretest probability of a bradycardia substrate.

    “The sensitivity and specificity of EPS to assess sinus node dysfunction and AV conduction disease in patients with syncope are variable, depending on patient selection and pretest probability of a bradycardia substrate (189–191).”

    From 2017 ACC/AHA/HRS Guideline for the Evaluation and Management of Patients With Syncope (2017) · cites this paper as [190]

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Authors
Scheinman, M. M., Peters, R. W., Sauvé, M. J., Desai, J., Abbott, J. A., Cogan, J., Wohl, B., & Williams, K.
Affiliations
United States Department of Veterans Affairs (US)
Corresponding author
Scheinman, Melvin M.
ORCID
Venue
The American Journal of Cardiology
Publisher
Elsevier BV
Published
1982-12
Volume
50
Issue
6
Pages
1316-1322
ISSN
0002-9149 (ISSN-L)
DOI
10.1016/0002-9149(82)90469-6
OpenAlex
W2098390766
Cited by
249
References
0
Citations by year
2026: 2 · 2025: 3 · 2024: 4 · 2023: 1 · 2022: 8 · 2021: 15 · 2020: 3 · 2019: 5 · 2018: 15 · 2017: 9 · 2016: 3 · 2015: 1 · 2014: 8 · 2013: 11 · 2012: 6
FWCI
5.73
Type
journal article
Language
en
Open access
closed
Licence
www.elsevier.com/tdm/userlicense/1.0/ (tdm)
Locations
  • The American Journal of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
Keywords
bundle branch block, His bundle electrogram, high-grade atrioventricular block, sudden death, mortality, neurological symptoms, risk stratification
MeSH terms
Aged, Bundle of His, Bundle-Branch Block, Cardiac Pacing, Artificial, Electrocardiography, Follow-Up Studies, Heart Block, Humans, Middle Aged, Risk

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