[Sudden cardiac death as a consequence of heart conduction disorders. II. Sudden cardiac death in lesions of the heart conduction system]

Abstract

The conduction system in 31 patients (average age 43 years) who died suddenly and unexpectedly is analyzed. Seven cases show essential lesions of the conduction tissue, these lesions being the only pathological findings at all in 5 cases. The loss of conducting fibers is severe and fulfills our morphological criteria for av-block (see Part I). Considering these lesions are the only pathologic findings, there is every reason to believe that these patients died of Adams-Stokes attacks. Lack of evidence of a basic disease means that there is idiopathic loss of conducting fibers. The site of the lesion is mainly the branching bundle and the origin of both bundle branches. Fibrosis is never a main feature, and this is why the author is reluctant to characterize the disease simply as bilateral bundle branch fibrosis.