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(Circulation. 1970;42:409.)
© 1970 American Heart Association, Inc.

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The Pathogenesis of Atrioventricular Block in Coronary Disease

MAURICE LEV M.D.¹; SUMAN G. KINARE M.D.¹; ALFRED PICK M.D.¹

¹ From the Congenital Heart Disease Research and Training Center, Hektoen Institute for Medical Research; The Cardiovascular Institute, Michael Reese Hospital and Medical Center; Departments of Pathology of Northwestern University Medical School, University of Chicago School of Medicine, and University of Illinois College of Medicine, Chicago, Illinois.

The hypothesis that the pathogenesis of acute and chronic atrioventricular (A-V) block in coronary disease is different is investigated. The conduction systems of two cases of acute A-V block and four cases of chronic A-V block associated with coronary disease were studied by serial section. This showed that acute blocks in coronary disease are related to ischemia. Chronic blocks, however, have a mechanical factor associated with the ischemic factor. The mechanical factor is related to the effect of fibrosis and calcification of the summit of the ventricular septum upon the branching portion of the A-V bundle and the left bundle branch.

Key Words: Arteriosclerosis • Atrioventricular bundle • Bundle of His • Conduction system • Coronary disease • Left bundle-branch fascicles

Submitted on March 17, 1970
Accepted on May 20, 1970

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