The DOI matches its Crossref record; 21 of the 21 references it cites were found in a registry or an index.
Electrophysiologic testing in bundle branch block and unexplained syncope
Abstract
Thirty-two patients with bundle branch block and unexplained syncope underwent electrophysiologic testing, including programmed ventricular stimulation with up to triple extrastimuli. The infranodal conduction time (HV) was 70 ms or greater in 12 patients. Pathologic infranodal block during atrial pacing occurred in 2 patients. Unimorphic ventricular tachycardia (VT) was induced in 9 patients (28%) and polymorphic VT in 5 (16%). A permanent pacemaker was implanted in patients with infranodal block during atrial pacing and, generally, in patients with an HV of 70 ms or more. Patients with inducible unimorphic or sustained polymorphic VT were treated with an antiarrhythmic drug. The mean follow-up period was 19 +/- 14 months (+/- standard deviation). Three patients died suddenly: a noncompliant patient with inducible sustained VT; a patient with a normal electrophysiologic study treated empirically with quinidine for premature ventricular complexes; and a patient with an HV of 70 ms and no inducible VT treated with a permanent pacemaker. The actuarial incidence of sudden death was 10% at 45 months of follow-up. Only 2 patients had recurrent syncope; both had a normal electrophysiologic study. Approximately 50% of patients with bundle branch block and unexplained syncope who undergo electrophysiologic testing are found to have a clinically significant abnormality (HV of 70 ms or more, infranodal block during atrial pacing and inducible unimorphic VT), and some patients have more than 1 abnormality. Long-term management guided by the results of electrophysiologic testing generally is successful in preventing recurrent syncope.(ABSTRACT TRUNCATED AT 250 WORDS)
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“a high incidence of total deaths (about one-third sudden) was observed in patients with BBB and heart failure, previous myocardial infarction, or low ejection fraction. 345-347”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [346]
In the citing paper
“Although syncope is not associated with an increased incidence of sudden death in patients with preserved cardiac function”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [346]
In the citing paper
“Unfortunately, ventricular programmed stimulation does not seem to identify these patients correctly”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [346]
Citations
Cites
Natural History of High-Risk Bundle-Branch Block: Final Report of a Prospective Study
McAnulty, J. H., Rahimtoola, S. H., Murphy, E., DeMots, H., Ritzmann, L., Kanarek, P. E., & Kauffman, S. (1982) · New England Journal of Medicine · doi:10.1056/nejm198207153070301 · Cited by 319
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Self-citationIntracardiac Electrophysiologic Techniques in Recurrent Syncope of Unknown Cause
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Clinical pharmacology and therapeutic applications of the antiarrhythmic agent, amiodarone
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Electrophysiologic testing in the evaluation of patients with syncope of undetermined origin
Hess, D., Morady, F., & Scheinman, M. M. (1982) · The American Journal of Cardiology · doi:10.1016/0002-9149(82)90468-4 · Cited by 154
Self-citationMorady, F., SHEN, E. N., Schwartz, A. B., Hess, D., Bhandari, A. K., Sung, R. J., & Scheinman, M. M. (1983) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(83)80329-5 · Cited by 137
Self-citationSyncope in Patients with Chronic Bifascicular Block
Dhingra, R. C., DENES, P., Wu, D., Chuquimia, R., AMAT-Y-LEON, F., Wyndham, C. R. C., & ROSEN, K. M. (1974) · Annals of Internal Medicine · doi:10.7326/0003-4819-81-3-302 · Cited by 133
Role of Cardiac Electrophysiologic Studies in Patients with Unexplained Recurrent Syncope
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Sudden Death in Patients With Chronic Bifascicular Block
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A Prospective Study of Sudden Death in “High-Risk” Bundle-Branch Block
McAnulty, J. H., Rahimtoola, S. H., Murphy, E. S., Kauffman, S., Ritzmann, L. W., Kanarek, P., & DeMots, H. (1978) · New England Journal of Medicine · doi:10.1056/nejm197808032990501 · Cited by 110
Electrophysiologic evaluation of syncope in patients with bifascicular block
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Programmed ventricular stimulation in patients without spontaneous ventricular tachycardia
Morady, F., Shapiro, W., SHEN, E. N., Sung, R. J., & Scheinman, M. M. (1984) · American Heart Journal · doi:10.1016/0002-8703(84)90821-4 · Cited by 65
Self-citationElectrophysiologic Effects of Procaine Amide in Patients with Intraventricular Conduction Delay
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ACC/AHA/HRS 2008 guidelines for device-based therapy of cardiac rhythm abnormalities
Epstein, A. E., DiMarco, J. P., Ellenbogen, K. A., Estes, N. A. M., Freedman, R. A., Gettes, L. S., Gillinov, A. M., Gregoratos, G., Hammill, S. C., Hayes, D. L., et al. (2008) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2008.02.032 · Cited by 2,546
2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab364 · Cited by 2,019
Zipes, D. P., Camm, A. J., Borggrefe, M., Buxton, A. E., CHAITMAN, B. R., FROMER, M. A., Gregoratos, G., Klein, G. J., Myerburg, R. J., Quiñones, M. A., et al. (2006) · Journal of the American College of Cardiology · doi:10.1016/j.jacc.2006.07.010 · Cited by 1,975
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951
ACC/AHA/HRS 2008 Guidelines for Device-Based Therapy of Cardiac Rhythm Abnormalities
Epstein, A. E., Dimarco, J., Ellenbogen, K. A., Estes, N. A. M., Freedman, R. A., Gettes, L. S., Gillinov, A. M., Gregoratos, G., Hammill, S. C., Hayes, D. L., et al. (2008) · Circulation · doi:10.1161/circualtionaha.108.189742 · Cited by 1,772
Metadata
- Authors
- Morady, F., Higgins, J., Peters, R. W., Schwartz, A. B., Shen, E. N., Bhandari, A., Scheinman, M. M., & Sauvé, M. J.
- Affiliations
- University of California, San Francisco (US)
- Corresponding author
- Morady, Fred
- Venue
- The American Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 1984-09
- Volume
- 54
- Issue
- 6
- Pages
- 587-591
- ISSN
- 0002-9149 (ISSN-L)
- OpenAlex
- W2059208803
- Cited by
- 138
- References
- 21
- Citations by year
- 2026: 1 · 2023: 1 · 2022: 5 · 2021: 4 · 2020: 4 · 2019: 2 · 2018: 9 · 2017: 7 · 2016: 3 · 2012: 2
- FWCI
- 5.78
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The American Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Syncope and Autonomic Disorders
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Keywords
- bundle branch block, unexplained syncope, electrophysiologic testing, programmed ventricular stimulation, polymorphic ventricular tachycardia, permanent pacemaker, antiarrhythmic drugs, sudden death, recurrent syncope, quinidine
- MeSH terms
- Adolescent, Adult, Aged, Bundle-Branch Block, Cardiac Pacing, Artificial, Child, Death, Sudden, Electrocardiography, Female, Humans, Male, Middle Aged, Pacemaker, Artificial, Syncope, Tachycardia
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