Intraventricular conduction delay's need to be differentiated from other conditions resulting in wide QRS complex such as LVH, pacemaker rhythms and accessory pathway arrythmias. Causes can be classified based upon the site of pathology in the ventricular conduction system as well as the associated medical condition.ĭifferentiating Intraventricular Conduction Delay from other Disorders These abnormalities can be due to pathology in either the left bundle of His or its fascicular branches or the right bundle of His or its combination resulting in changes to the QRS complex. Intraventricular conduction delays(IVCDs) refers to abnormalities in the intraventricular propagation of supraventricular impulses. Intraventricular conduction delay involves a variety of disturbances of the His-Purkinje/ventricular conduction system that affects the electrocardiogram (ECG) in distinctive ways and may or may not lead to a wide QRS complex and/or axis deviation. However, the anatomic description of conduction abnormalities are not intended to localize sites of impaired function precisely because the electrocardiographic changes may be caused by abnormalities in various sites within the ventricles. Intraventricular conduction disturbances can be broadly classified based upon the underlying physiology or based upon the site of block (anatomical classification). Intraventricular conduction delay can be caused by structural abnormalities in the bundle of His or Purkinje system or ventricular myocardium, functional refractoriness in a portion of the conduction system (i.e., aberrant ventricular conduction) or ventricular preexcitation over a bypass tract. The normal intraventricular system starts at the AV node as bundle of His that divides into right and left bundle branches which after giving of the fascicular branches ends in the complex Purkinje system. Intraventricular conduction delay are due to abnormalities in the specialized conduction system in the ventricles that transmit impulses arising from the SA node transmitted through the AV node to the ventricles. Abnormalities of local myocardial activation can further alter the specific pattern of venticular activation. An IVCD is the result of abnormal activation of the ventricles caused by conduction delay or block in one or more parts of the specialized conduction system ( bundle of His, bundle branch or purkinje conduction system) resulting in widening of QRS complex. The QRS complex represents electrical activation of the ventricle and normally the entire process of ventricular depolarization in adults is completed within about 0.1 sec (100 msec). The term intraventricular conduction delay or intraventricular conduction disturbances ( IVCDs) refers to disturbances in the intraventricular propagation of supraventricular impulses resulting in changes in the QRS complex either in morphology or duration, or both. Associate Editor(s)-in-Chief: Mugilan Poongkunran M.B.B.S Overview Risk calculators and risk factors for Intraventricular conduction delay overviewĮditor-In-Chief: C. To Hospitals Treating Intraventricular conduction delay overview Intraventricular conduction delay overview in the newsīlogs on Intraventricular conduction delay overview Intraventricular conduction delay overview On the WebįDA on Intraventricular conduction delay overviewĬDC onIntraventricular conduction delay overview Natural History, Complications and Prognosis Intraventricular conduction delay Microchaptersĭifferentiating Intraventricular conduction delay from other Disorders
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