Abstract
The cardiac surgery has made a remarkable progress in recent years. On the other hand, various types of arrhythmias following open heart surgery have become serious clinical problems. In the present study a series of the cases of complete right bundle branch block with left anterior hemiblock (CRBBB c LAH) following a radical operation for an ventricular septal defect (VSD) and tetralogy of Fallot (TF) was analyzed in terms of the function of the coducting system.CRBBB coupled with LAH occured in 5 of 43 total cases (11.6%) following operation for VSD and TF. The percentage agrees with that reported by other authors. Measurement of the intervals of the cardiac cycle in electrocardiograms of the bundle of His (HBE) showed normal values except in 2 cases of VSD in which the H-V interval was prolonged to 55 msec. After right atrial pacing all conductions were found to retain 1 to 1 correspondence even at a maximum pacing rate of 240 per minute. The sinus node recovery time (SNRT) (460-1080 msec) corrective sinus node recovery time (CSRT) (-40 -355 msec), measured by the overdrive and suppression test, were both within the normal range. Measurements of the A-V node effective refractory period (AVN-ERP) and A-V node functional refractory period (AVN-FRP) showed normal values in all 4 cases.During an observation period of twelve to thirty-four months, all patients convalesced without any evidence of complete heart block and Adams-Stocks attack, showing normal sinus rhythm. These results are in agreement with other data recently published.
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