Arrival of excitation at the right ventricular apical endocardium in Wolff Parkinson White syndrome type B

B. Befeler, Agustin Castellanos, C. A. Castillo, A. S. Agha, M. C. Vagueiro, Robert J Myerburg

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

His bundle and bipolar right ventricular apex (RVA) and right ventricular outflow tract (RVOT) catheter electrograms taken from sites 1 mm apart were recorded simultaneously with various surface leads in two patients with Wolff Parkinson White syndrome (WPW) type B. In 'fusion' beats the presence of a normal H RVA interval indicated that the apex of the right ventricle was activated by the impulse emerging from the right branch. On the other hand, a shorter than normal H RVA interval implied that the RVA was depolarized by the activation front propagating from the preexcited site. When this occurred, the V RVA intervals gave a rough estimate of conduction time from preexcited area to RVA. The values obtained (40 and 50 msec, respectively) were shorter than in two other patients with WPW type A. The arrival of excitation patterns in the right ventricular endocardium were similar in WPW type B and in beats produced by RVA stimulation but differed markedly from that of left anterior hemiblock even when the surface electrocardiographic leads showed abnormal left axis deviation in all instances. This resemblance between ventricular complexes attributed to WPW type B and those resulting from stimulation of an inferior (apical) site suggests, but does not prove, that the impulses propagated from an equivalent region of the right ventricle. These simultaneously recorded His bundle and right ventricular endocardial electrograms during electrical stimulation of the heart have increased our knowledge of Wolff Parkinson White syndrome.

Original languageEnglish
Pages (from-to)655-660
Number of pages6
JournalCirculation
Volume48
Issue number3
StatePublished - Dec 1 1973
Externally publishedYes

Fingerprint

Endocardium
Wolff-Parkinson-White Syndrome
Bundle of His
Heart Ventricles
Electric Stimulation
Catheters

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Befeler, B., Castellanos, A., Castillo, C. A., Agha, A. S., Vagueiro, M. C., & Myerburg, R. J. (1973). Arrival of excitation at the right ventricular apical endocardium in Wolff Parkinson White syndrome type B. Circulation, 48(3), 655-660.

Arrival of excitation at the right ventricular apical endocardium in Wolff Parkinson White syndrome type B. / Befeler, B.; Castellanos, Agustin; Castillo, C. A.; Agha, A. S.; Vagueiro, M. C.; Myerburg, Robert J.

In: Circulation, Vol. 48, No. 3, 01.12.1973, p. 655-660.

Research output: Contribution to journalArticle

Befeler, B, Castellanos, A, Castillo, CA, Agha, AS, Vagueiro, MC & Myerburg, RJ 1973, 'Arrival of excitation at the right ventricular apical endocardium in Wolff Parkinson White syndrome type B', Circulation, vol. 48, no. 3, pp. 655-660.
Befeler B, Castellanos A, Castillo CA, Agha AS, Vagueiro MC, Myerburg RJ. Arrival of excitation at the right ventricular apical endocardium in Wolff Parkinson White syndrome type B. Circulation. 1973 Dec 1;48(3):655-660.
Befeler, B. ; Castellanos, Agustin ; Castillo, C. A. ; Agha, A. S. ; Vagueiro, M. C. ; Myerburg, Robert J. / Arrival of excitation at the right ventricular apical endocardium in Wolff Parkinson White syndrome type B. In: Circulation. 1973 ; Vol. 48, No. 3. pp. 655-660.
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