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Natural history of infra-His atrioventricular block induced by atrial pacing in symptomatic patients with chronic bundle branch block

We prospectively studied the natural history of infra-His atrioventricular (AV) block induced by atrial pacing (AP) in patients (Pts) with chronic bundle branch block (BBB) and syncope, comparing 204 Pts with normal response to AP (Group I) to 18 Pts with infra-His induced AV block (Group II). During a mean period of 5.4 years, a progression to high degree AV block was higher in Group II than in Group I (78% versus 7%, p<0.001). After prophylactic pacing, a prognosis of Pts in Group II depended of severity of underlying heart disease. Symptomatic Pts with chronic BBB and infra-His block induced by AP had absolute indication for cardiac pacing.

Infra-His AV block; atrial pacing; bundle branch block

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