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http://dx.doi.org/10.1378/chest.60.4.391DOI Listing

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Background: Permanent pacing is often considered for patients with syncope and bifascicular block.

Objective: The purpose of this study was to determine whether QRS morphology or other electrocardiographic characteristics can identify patients who may benefit from permanent pacing.

Methods: The Syncope: Pacing or Recording in the Later Years (SPRITELY) trial was a multicenter trial that randomized patients with bifascicular block and syncope (n = 115) to empiric pacemaker implantation vs implantable loop recorder (ILR) monitoring.

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Complete Atrioventricular Block: A Rare Complication of MitraClip Implantation.

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Division of Cardiovascular Diseases and Cardiovascular Surgery, Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey, USA.

MitraClip (Abbott Vascular, Inc., Santa Clara, California) has emerged as a viable alternative for treatment of symptomatic severe mitral regurgitation. Conduction abnormalities are not a known complication of this procedure.

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For the provocation of trifascicular blockings in patients with fascicular block a rapid ventricular stimulation after an application of ajmalin of maximally 100 mg performed. Of 80 patients with clinically and electrocardiographically certain intermitting total atrioventricular blockings (group A) and 24 patients with typical anamnesis without ECG-proof of the atrioventricular block of higher degree (group B) altogether 88 patients had an atrioventricular block of 2nd or 3rd degree after provocation. On the other hand, only 2 of 20 patients with bifascicular block without syncopes (group C) had a positive result of the test.

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