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(Chest. 1973;63:358-362.)
© 1973 American College of Chest Physicians

His Bundle Electrograms in Healthy Adolescents with Persistent Second Degree A-V Block

Paul R. Lightfoot M.D.1; Lewis Sasse M.D.1; William J. Mandel M.D.2; and Hirokazu Hayakawa M.D.1

1 Departments of Cardiology, Kaiser-Permanente Hospitals, Cedars-Sinai Medical Center, and the Department of Medicine, University of California, Los Angeles
2 Milly Factor clinical investigator, Western Cardiac Foundation

His bundle recordings were obtained in two healthy young adult men without organic heart disease whose resting electrocardiograms demonstrated second degree A-V block with Wenckebach periods. The area of block was found to be proximal to the His bundle. Exercise and atropine produced both prompt sinus node acceleration and elimination of the A-V block. This evidence, coupled with additional pharmacologic studies, strongly indicated excessive vagal tone as a major causal factor in production of the electrocardiographic abnormalities in these patients.






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