trifascicular block

三枝ブロック

WordNet

1. a three-dimensional shape with six square or rectangular sides (同)cube
2. (computer science) a sector or group of sectors that function as the smallest data unit permitted; "since blocks are often defined as a single sector, the terms `block and `sector are sometimes used interchangeably"
3. support, secure, or raise with a block; "block a plate for printing"; "block the wheels of a car"
4. a solid piece of something (usually having flat rectangular sides); "the pyramids were built with large stone blocks"
5. housing in a large building that is divided into separate units; "there is a block of classrooms in the west wing"
6. a rectangular area in a city surrounded by streets and usually containing several buildings; "he lives in the next block" (同)city block
7. an inability to remember or think of something you normally can do; often caused by emotional tension; "I knew his name perfectly well but I had a temporary block" (同)mental_block
8. a number or quantity of related things dealt with as a unit; "he reserved a large block of seats"; "he held a large block of the companys stock"
9. interrupt the normal function of by means of anesthesia; "block a nerve"; "block a muscle"
10. run on a block system; "block trains"
11. shape by using a block; "Block a hat"; "block a garment"
12. shape into a block or blocks; "block the graphs so one can see the results clearly"
13. stamp or emboss a title or design on a book with a block; "block the book cover"
14. completely obstructed or closed off; "the storm was responsible for many blocked roads and bridges"; "the drain was plugged" (同)plugged
15. closed to traffic; "the repaving results in many blocked streets" (同)out of use
16. a group of countries in special alliance (同)axis
17. the act of obstructing or deflecting someones movements (同)block

PrepTutorEJDIC

1. (木・石などの,通例平らな面のある)『かたまり』 / 《米》(四団を街路に囲まれた)『区画』,街区 / 街区の1辺の距離(一般に40メートル前後) / 《英》ブロック(アパート・事務所・商店などに区切られている大きな建物) / 『妨害物』,障害物(obstacle);(障害によって生じた)停滞,渋滞 / 台木,台(まないた・肉切り台・まき割り台・せり売り台・帽子の木型など);《the~》炭頭台 / (特にアメリカンフットボールで)ブロック(相手の選手の突進を阻止する) / 滑車(pulley) / (座席券・株券などの)一組《+『of』+『名』》 / 〈通路など〉'を'『ふさぐ』,〈通行・進行など〉'を'妨げる / 〈帽子など〉の型取りをする / (特にアメリカンフットボールで)〈相手選手の突進〉'を'ブロックする;(ボクシングで)〈相手のパンチ〉'を'ブロックする
2. ブロック,圏(地理・共通の利害・政治・経済上の目的などのために団結した団体・国家などの結合体)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/09/28 15:33:33」(JST)

wiki en

[Wiki en表示]

Trifascicular heart block
Classification and external resources
Specialty	cardiology
ICD-10	I45.3
ICD-9-CM	426.54

Trifascicular block is a problem with the electrical conduction of the heart. It is diagnosed on an electrocardiogram (ECG/EKG) and has three features:

• prolongation of the PR interval (first degree AV block)
• right bundle branch block
• either left anterior fascicular block o posterior fascicular block]]

Differential diagnosis

Trifascicular block is important to diagnose because it is difficult to tell based on the surface ECG whether the prolonged PR interval is due to disease in the AV node or due to diffuse distal conduction system disease.

• In the former case, if the block at the AV node level becomes complete, the escape rhythm will originate from the bundle of His, which typically will generate heart rates in the 40s, allowing the individual to survive and complain of symptoms of fatigue or near-syncope to their physician.

• In the latter case, however, because the conduction system disease is diffuse in nature, the escape rhythm may be fascicular or ventricular, which may be at rates that are life-threateningly low.

Diagnosis

The diagnosis of whether the PR prolongation is due to AV nodal disease or diffuse conduction system disease is typically made by an electrophysiology study of the conduction system. In an electrophysiology study, trifascicular block due to AV nodal disease (true trifascicular block does not involve the AV node) block is represented by a prolonged AH interval (denoting prolonged time from impulse generation in the atria and conduction to the bundle of His) with a relatively preserved HV interval (denoting normal conduction from the bundle of His to the ventricles). Trifascicular block due to distal conduction system disease is represented by a normal AH interval and a prolonged HV interval.

Treatment

The treatment for diffuse distal conduction system disease is insertion of a pacemaker. If the PR prolongation is due to AV nodal disease, a case may be made for observation, as it may never progress to complete heart block with life threateningly low heart rates.

Regardless of where in the conduction system the block is, if the block is believed to be the cause of syncope in an individual, a pacemaker is an appropriate treatment.

References

External links

• http://library.med.utah.edu/kw/ecg/mml/ecg_0293_mod.html
• http://www.ecglibrary.com/trifas.html

See also

• Bifascicular block

UpToDate Contents

全文を閲覧するには購読必要です。 To read the full text you will need to subscribe.

• 1. 心室内伝導遅延への基本的アプローチ basic approach to delayed intraventricular conduction
• 2. 慢性二枝ブロックの経過および治療 course and treatment of chronic bifascicular block
• 3. 永久的心臓ペーシング：デバイスおよび適応の概要 permanent cardiac pacing overview of devices and indications
• 4. 心筋梗塞後の伝導異常 conduction abnormalities after myocardial infarction
• 5. 左脚前枝ブロック left anterior fascicular block

English Journal

• Practice makes perfect: relationship between hospital procedure volume and permanent pacemaker implantation after paroxysmal supraventricular tachycardia ablation.

• Agarwal V1,2, Shah N3, Mehta K4, Agarwal A5, Willner J6, Lafferty J6.
• Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing.J Interv Card Electrophysiol.2017 Nov;50(2):141-147. doi: 10.1007/s10840-017-0292-0. Epub 2017 Nov 13.
• PMID 29134433

• Alternating trifascicular block and cardiac memory.

• Danon A1, Shurrab M2.
• Journal of electrocardiology.J Electrocardiol.2017 Nov - Dec;50(6):966-968. doi: 10.1016/j.jelectrocard.2017.07.006. Epub 2017 Jul 12.
• PMID 28802655

• Generating Purkinje networks in the human heart.

• Sahli Costabal F1, Hurtado DE2, Kuhl E3.
• Journal of biomechanics.J Biomech.2016 Aug 16;49(12):2455-65. doi: 10.1016/j.jbiomech.2015.12.025. Epub 2015 Dec 22.
• PMID 26748729

Japanese Journal

• 術中心停止を来した慢性3枝ブロックの1症例

• 堀 耕太郎,舟尾 友晴,田中 克明 [他]
• 麻酔 59(2), 206-209, 2010-02
• NAID 40016986629

• 老研究者の覚え書 養育院時代(3) : 老年者の心臓刺激伝導系の形態学的研究 老年型房室伝導系病変の特徴 東大・養育院での研究追記

• 岡田 了三
• 群馬パース大学紀要 5, 681-711, 2007-09
• 養育院病院における老年者心臓刺激伝導系の連続切片による不整脈の形態学的研究は杉浦昌也、大川真一郎、平岡啓佑、嶋田祐之ら諸先生方との協同研究として1967年に開始された。(1)房室伝導障害の病因は虚血7、炎症2、非虚血性原発性8例(4例は重複病因)。途絶部位は虚血群では冠状動脈病変の分布に対応して房室結節・ヒス束・両脚と変化に富むが、心筋梗塞域とは微妙にズレのある例もみられた。原発性では中心線維体老 …
• NAID 110007045034

• Percutaneous Transluminal Septal Myocardial Ablation for Hypertrophic Obstructive Cardiomyopathy : Initial and Follow-up Results in the First 27 Patients

• Tsuchikane Etsuo,Takeda Yoshihiro,Kobayashi Tohru,Yachiku Kenji,Nasu Kenya,Kobayashi Yoshiki,Matsumoto Hiroaki,Awata Nobuhisa
• Circulation journal : official journal of the Japanese Circulation Society 67(9), 763-767, 2003-08-20
• … Although transient trifascicular block was observed in 14 patients, permanent pacemaker implantation was not required. …
• NAID 110002666399

Related Links

• Trifascicular block | definition of Trifascicular block by Medical ...

block [blok] obstruction. 1. to obstruct. regional anesthesia. 2. heart block. atrioventricular block 1. any interruption of the conduction of electrical impulses from the atria to the ventricles; it can occur at the level of the atria, the ...

• Trifascicular Block - Life in the Fastlane ECG Library

A review of the features of trifascicular block. ... Incomplete trifascicular block may progress to complete heart block, although the overall risk is low. Patients who present with syncope and have an ECG showing incomplete ...

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関連記事

「block」

「block」

　　[★]

• n.

• 遮断、塊、ブロック

• v.

• 遮断する、ブロックする、封鎖する、阻止する

関

blockade、blockage、deter、inhibit、inhibition、lump、prevent、prevention、repress、repression、seal、turn off