His bundle branch block – causes of the disease

His bundle block: what you should know about the pathology

His bundle block means slowing down or absence of impulse conduction with one, two or three His bundle fascicles in the area of the interventricular septum. This pathology is observed in about 1 % of people over 35.

Localization of His bundle block:

right branch;
left branch;
left anterior fascicular block;

left posterior fascicular block;
of the anterior medial divergence;

bifascicular and trifascicular heart blocks.

The block may be complete and incomplete (degree of conductivity), sustained and transient. A cardiologist will tell you about possible risks of His bundle block during your visit.

Causes of the disease and factors provoking it

Intraventricular conduction disorders may be caused by the following:

ischemic heart disease (IHD);
hypertensive disease;
cardiomyopathies;
cardiac valve disease;

primary degenerative lesions of cardiac conduction system (Lenegre disease) or heart calcification (Lev disease);

rheumatic disease;
viral or bacterial myocarditis;
in some cases it is impossible to determine the causes.

You can book a visit to cardiologist and get answers on your questions related to the pathology on our website. A doctor will prescribe the required examination and tell about the treatment of the patients with His bundle blocks.

Clinical signs of the disease

His bundle block often shows no symptoms, and it is often diagnosed by accident during ECG. Clinical signs are often provoked by an underlying disease, its complications, severity of the structural cardiac disease.

Diagnostics of the pathology, signs of His bundle block on ECG

Principal diagnostic techniques are:

electrocardiography (ECG);

daily ECG monitoring;

esophageal electrocardiography.

Echocardiography, MRI and multispiral computed tomography (MSCT) will help to detect organic heart lesions. A cardiologist may prescribe additional examination techniques during a check-up.

Signs of His bundle block on ECG:

In case of complete His bundle block, the duration of QRS complex is 0.12 sec and above (in the normal condition: 0.08–0.10 sec). QRS complex in the leads V1-V2 has rsR “ or rSR” graph with the oblique downward displacement of ST segment, up-convex, that passes into a negative asymmetric T wave.

In case of complete His bundle block, the duration of QRS complex is 0.12 sec and above, and the time of internal deviation in sinistral chest lead exceeds 0.05 sec. In the leads I, V5 and V6 the QRS complex is represented with one exaggerated, distorted, split R wave that passes into the oblique downward ST segment, up-convex, with the following negative asymmetric T wave.

Treatment of His bundle block

The treatment of the pathology may be non-surgical (therapy of the underlying disease) and surgical (implantation of a pacemaker). Determination of treatment approach depends on the degree and localization of the block, clinical picture and comorbidities.

Prognosis

In this case, the prognosis depends on the underlying disease, as His bundle block is just its symptom.

If you have any questions related to your health, book an appointment and get a consultation by a doctor. You can book an appointment on the website and at the specified phone numbers.

Article author - Sergey Poyarkov

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