PAROXYSMAL NON-REENTRANT TACHYCARDIAS DUE TO SIMULTANEOUS CONDUCTION IN DUAL ATRIOVENTRICULAR NODAL PATHWAYS

被引:69
作者
CSAPO, G [1 ]
机构
[1] REHABIL CTR HEART & CIRCULATORY DIS, BAD KROZINGEN, FED REP GER
关键词
D O I
10.1016/0002-9149(79)90371-0
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Electrophysiologic studies were performed in a 41 year old man for analysis of paroxysmal tachycardias appearing in various electrocardiographic patterns of supraventricular and ventricular bigeminy, junctional and ventricular tachycardia and atrial fibrillation, among others. All these arrhythmias were due to dual atrioventricular (A-V) nodal pathways with simultaneous dual fast and stow conduction of single atrial beats at a normal basic sinus rate. Moderate changes in sinus rate and in fast or slow pathway conduction times, or both, changed the position of the slowly conducted beats between the neighboring two fast conducted beats and resulted in various electrocardiographic manifestations of the conduction disturbance. Different blocks, such as second degree type I, 2:1, 3:1 and possibly also type II, in one of the two pathways and occasionally aberrant conduction induced even more unusual tracings. After intravenous injection of 25 mg of ajmaline, unexpected lengthening and shortening of the A-H interval occurred, suggesting variable shifts between fast and slow pathway conduction. The incidence of dual A-V nodal pathways is discussed; it was documented in 17 (4.2 percent) of 405 patients studied. A theoretical model of A-V nodal conduction is proposed to explain its normal properties and abnormal patterns. © 1979.
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页码:1033 / 1045
页数:13
相关论文
共 33 条
[1]   PARTICIPATION OF FAST AND SLOW AV NODAL PATHWAYS IN TACHYCARDIAS COMPLICATING WOLFF-PARKINSON-WHITE SYNDROME - REPORT OF A CASE [J].
AMATYLEON, F ;
WYNDHAM, C ;
WU, D ;
DENES, P ;
DHINGRA, RC ;
ROSEN, KM .
CIRCULATION, 1977, 55 (04) :663-668
[2]   DIGITALIS-INDUCED LONGITUDINAL DISSOCIATION IN CANINE CARDIAC PURKINJE-FIBERS [J].
BAILEY, JC ;
ANDERSON, GJ ;
FISCH, C .
AMERICAN JOURNAL OF CARDIOLOGY, 1973, 32 (02) :202-208
[3]   THE MECHANISM OF AURICULAR PAROXYSMAL TACHYCARDIA [J].
Barker, Paul S. ;
Wilson, Frank N. ;
Johnston, Franklin D. .
AMERICAN HEART JOURNAL, 1943, 26 (04) :435-445
[4]   ATRIOVENTRICULAR-CONDUCTION PATTERNS IN PATIENTS WITH PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA [J].
BISSETT, JK ;
SOYZA, ND ;
KANE, JJ ;
MURPHY, ML .
AMERICAN HEART JOURNAL, 1976, 91 (03) :287-291
[5]   SUPERNORMAL-CONDUCTION OF A PREMATURE IMPULSE UTILIZING FAST PATHWAY IN A PATIENT WITH DUAL ATRIOVENTRICULAR NODAL PATHWAYS [J].
DENES, P ;
WYNDHAM, CRC ;
WU, D ;
ROSEN, KM .
CIRCULATION, 1975, 51 (05) :811-814
[6]  
DENES P, 1975, BRIT HEART J, V37, P1069
[7]   DEMONSTRATION OF DUAL A-V NODAL PATHWAYS IN PATIENTS WITH PAROXYSMAL SUPRAVENTRICULAR TACHYCARDIA [J].
DENES, P ;
WU, D ;
DHINGRA, RC ;
CHUQUIMIA, R ;
ROSEN, KM .
CIRCULATION, 1973, 48 (03) :549-555
[8]   DETERMINANTS OF ATRIOVENTRICULAR NODAL RE-ENTRANCE WITH PREMATURE ATRIAL STIMULATION IN PATIENTS WITH DUAL AV NODAL PATHWAYS [J].
DENES, P ;
WU, D ;
AMATYLEON, F ;
DHINGRA, R ;
WYNDHAM, CR ;
ROSEN, KM .
CIRCULATION, 1977, 56 (02) :253-259
[9]  
GROLLEAU R, 1974, ARCH MAL COEUR VAISS, V67, P13
[10]  
GUIZE L, 1978, ARCH MAL COEUR VAISS, V71, P159