To Pace or Not to Pace
Authors: NICHOLAS P. DEPASQUALE
Journal: Annals of Internal Medicine (1974)

Editorials1 September 1974To Pace or Not to PaceNICHOLAS P. DEPASQUALE, M.D., MICHAEL S. BRUNO, M.D.NICHOLAS P. DEPASQUALE, M.D.Search for more papers by this author, MICHAEL S. BRUNO, M.D.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-81-3-395 SectionsAboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail ExcerptInductive reasoning supported by experimental study and clinicopathologic correlation has yielded electrocardiographic criteria for the diagnosis of various combinations of block within the three divisions of the intraventricular conduction system (1-3). A central issue regarding the implications of intraventricular block was raised a few years ago, when it was reported that most of a group of patients with complete heart block had combined right bundle-branch block and left anterior hemiblock (bifascicular block) during orthograde conduction (4). As a result of this and similar studies physicians began to question whether patients with bifascicular block should have prophylactic permanent pacemaker insertion or...References1. ROSENBAUM M: The hemiblocks: diagnostic criteria and clinical significance. Mod Concepts Cardiovasc Dis 39:141-146, 1970 MedlineGoogle Scholar2. WATTPRUITT TR: Character, cause and consequence of combined left axis deviation and right bundle branch block in human electrocardiogram. Am Heart J 77:460-465, 1969 CrossrefMedlineGoogle Scholar3. LENEGRE J: Etiology and pathology of bilateral bundle branch block in relation to complete heart block. Prog Cardiovasc Dis 409-444, 1969 Google Scholar4. LASSERHAFTFRIEDBERG RJC: Relationship of right bundle branch block and marked left axis deviation (with left parietal or peri-infarction block) to complete heart block and syncope. Circulation 37:429-437, 1968 CrossrefMedlineGoogle Scholar5. DEPASQUALEBRUNO NM: Natural history of combined right bundle branch block and left anterior hemiblock. Am J Med 54:297-303, 1973 CrossrefMedlineGoogle Scholar6. KUNSTADTPUNJACAGIN DMN: Bifascicular block: a clinical and electrophysiologic study. Am Heart J 86:173-181, 1973 CrossrefMedlineGoogle Scholar7. KULBERTUS H: The magnitude of risk of developing complete heart block in patients with LAD-RBBB (annotation). Ibid., pp. 278-280 Google Scholar8. DHINGRAROSENRAHIMTOOLA RKS: Normal conduction intervals and responses in sixty-one patients using His bundle recording and atrial pacing. Chest 64:55-59, 1973 CrossrefMedlineGoogle Scholar9. DEMOULINKULBERTUS JH: Histopathological examination of concept of left hemiblock. Br Heart J 34:807-814, 1972 CrossrefMedlineGoogle Scholar This content is PDF only. To continue reading please click on the PDF icon. Author, Article, and Disclosure InformationAuthors: NICHOLAS P. DEPASQUALE, M.D.; MICHAEL S. BRUNO, M.D.Affiliations: Department of Medicine Lenox Hill Hospital New York PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byLeft bundle branch block: A continuously evolving conceptBundle branch blockLiteraturObscure Syncope and the Sick Sinus SyndromeChronic bilateral bundle-branch block. Long-term observations in ambulatory patients.Anesthetic Management of Patients with Cardiac Disease 1 September 1974Volume 81, Issue 3Page: 395-396KeywordsElectrocardiographyHeartPacemakersPatient advocacyReasoningRight bundle branch block ePublished: 1 December 2008 Issue Published: 1 September 1974 PDF downloadLoading ...