Progression of intrahisian atrioventricular block: Will this presage a renaissance of His-bundle studies?

In this issue of HeartRhythm is a very interesting article by Ragupathi et  al,1 who describe the natural history of patients with putative intrahisian atrioventricular (AV) block. The authors have nicely shown that although these patients often present with traumatic and very worrisome syncopal episodes, they seem to have a very low incidence of progression to complete A V block. There are 2 major clinical extrapolations of these observations. First, the low incidence of right ventricular pacing would seem to obviate the risk for development of cardiac failure as a result of asynchronous right ventricular pacing; hence, consideration for biventricular pacing seems n ot to be an issue.

Source: Heart Rhythm - May 11, 2018 Category: Cardiology Authors: Melvin M. Scheinman Tags: Editorial Commentary Source Type: research