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. 1991 Jun;65(6):317–321. doi: 10.1136/hrt.65.6.317

A quantitative histopathological study of right bundle branch block complicating acute anteroseptal myocardial infarction.

M Okabe 1, K Fukuda 1, Y Nakashima 1, T Hiroki 1, K Arakawa 1, M Kikuchi 1
PMCID: PMC1024674  PMID: 2054240

Abstract

The aim of the present study was to evaluate whether necrosis of the right bundle branch is responsible for development of right bundle branch block in acute myocardial infarction. Twenty patients with acute anteroseptal myocardial infarction were studied--10 with right bundle branch block (group A) and 10 without (group B)--to evaluate by serial sectioning the pathological extent of myocardial infarction surrounding the right bundle branch and also that of right bundle branch necrosis. Myocardial infarction reached the right bundle branch more than 8 mm above the moderator band in all of group A, whereas myocardial infarction reached the right bundle branch less than 3 mm above the moderator band in only three patients in group B. Nine hearts in group A showed significant necrosis of the right bundle branch. In group B and in one case with transient right bundle branch block no necrosis was found. The occurrence of right bundle branch block was almost entirely explained by necrosis of the right bundle branch, but transient right bundle branch block did develop without necrosis of the right bundle branch.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. BAGDONAS A. A., STUCKEY J. H., PIERA J., AMER N. S., HOFFMAN B. F. Effects of ischemia and hypoxia on the specialized conducting system of the canine heart. Am Heart J. 1961 Feb;61:206–218. doi: 10.1016/0002-8703(61)90577-4. [DOI] [PubMed] [Google Scholar]
  2. BLONDEAU M., RIZZON P., LENEGRE J. [Auriculo-ventricular conduction disorders in recent myocardial infarct. II. Anatomical study]. Arch Mal Coeur Vaiss. 1961 Oct;54:1104–1117. [PubMed] [Google Scholar]
  3. Becker A. E., Lie K. I., Anderson R. H. Bundle-branch block in the setting of acute anteroseptal myocardial infarction. Clinicopathological correlation. Br Heart J. 1978 Jul;40(7):773–782. doi: 10.1136/hrt.40.7.773. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Fukuda K. Histopathological study on the conduction system with complete atrioventricular block--with special reference to configuration of QRS complex. Jpn Circ J. 1978 Nov;42(11):1265–1278. doi: 10.1253/jcj.42.1265. [DOI] [PubMed] [Google Scholar]
  5. Fukuda K., Nakata Y., Okada R., Takagi T. Histopathological study on the conduction system of complete right bundle branch block with references to configuration of QRS complex. Jpn Heart J. 1979 Nov;20(6):831–844. doi: 10.1536/ihj.20.831. [DOI] [PubMed] [Google Scholar]
  6. GREENSPAN K., CRANEFIELD P. F. Influence of some factors on oxygen uptake of canine cardiac Purkinje fibers. Am J Physiol. 1963 Jan;204:5–8. doi: 10.1152/ajplegacy.1963.204.1.5. [DOI] [PubMed] [Google Scholar]
  7. Hackel D. B., Wagner G., Ratliff N. B., Cies A., Estes E. H., Jr Anatomic studies of the cardiac conducting system in acute myocardial infarction. Am Heart J. 1972 Jan;83(1):77–81. doi: 10.1016/0002-8703(72)90108-1. [DOI] [PubMed] [Google Scholar]
  8. Horan L. G., Flowers N. C., Tolleson W. J. Thomas JR: The significance of diagnostic Q waves in the presence of bundle branch block. Chest. 1970 Sep;58(3):214–220. doi: 10.1378/chest.58.3.214. [DOI] [PubMed] [Google Scholar]
  9. Hunt D., Lie J. T., Vohra J., Sloman G. Histopathology of heart block complicating acute myocardial infarction. Correlation with the His bundle electrogram. Circulation. 1973 Dec;48(6):1252–1261. doi: 10.1161/01.cir.48.6.1252. [DOI] [PubMed] [Google Scholar]
  10. Lie K. I., Wellens H. J., Schuilenburg R. M., Becker A. E., Durrer D. Factors influencing prognosis of bundle branch block complicating acute antero-septal infarction. The value of his bundle recordings. Circulation. 1974 Nov;50(5):935–941. doi: 10.1161/01.cir.50.5.935. [DOI] [PubMed] [Google Scholar]
  11. Moir T. W. Study of luminal coronary collateral circulation in the beating canine heart. Circ Res. 1969 May;24(5):735–744. doi: 10.1161/01.res.24.5.735. [DOI] [PubMed] [Google Scholar]
  12. Myers W. W., Honig C. R. Amount and distribution of Rb-86 transported into myocardium from ventricular lumen. Am J Physiol. 1966 Sep;211(3):739–745. doi: 10.1152/ajplegacy.1966.211.3.739. [DOI] [PubMed] [Google Scholar]
  13. Norris R. M., Mercer C. J., Croxson M. S. Conduction disturbances due to anteroseptal myocardial infarction and their treatment by endocardial pacing. Am Heart J. 1972 Oct;84(4):560–566. doi: 10.1016/0002-8703(72)90480-2. [DOI] [PubMed] [Google Scholar]
  14. Scheinman M., Brenman B. Clinical and anatomic implications of intraventricular conduction blocks in acute myocardial infarction. Circulation. 1972 Oct;46(4):753–760. doi: 10.1161/01.cir.46.4.753. [DOI] [PubMed] [Google Scholar]
  15. Sutton R., Davies M. The conduction system in acute myocardial infarction complicated by heart block. Circulation. 1968 Nov;38(5):987–992. doi: 10.1161/01.cir.38.5.987. [DOI] [PubMed] [Google Scholar]

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