Sites of Conduction Disease in Aortic Stenosis

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Abstract
Electrophysiologic studies were done in 32 patients with aortic stenosis. In 24 patients with intact A-V [atrioventricular] conduction, A-H intervals ranged from 55-145 ms and were prolonged in 2. Two had split His bundle potentials. The H-V intervals ranged from 25-94 ms and were prolonged in 12. The mean H-V interval was 63 .+-. 2.6 ms. in 12 patients with calcific aortic stenosis compared with 50 .+-. 4.9 ms in 12 without calcification (P < 0.05). The mean H-V in 10 patients with aortic gradients > 40 mm Hg was 62 .+-. 5.6 ms compared with 47 .+-. 3.1 ms in 9 with gradients < 40 (P < 0.05). In patients with aortic stenosis and A-V block the site of the block was distal to the His bundle in 3 and within the His bundle in 5. All 8 had calcified valves. Aortic stenosis was commonly associated with latent and manifest conduction disease in the His bundle and the trifascicular conduction system. Conduction disease was more extensive with calcified valves and greater valve obstruction.