Dual AV nodal pathways and AV nodal reentrant paroxysmal tachycardia

TY - JOUR

T1 - Dual AV nodal pathways and AV nodal reentrant paroxysmal tachycardia

AU - Rosen, Kenneth M.

AU - Bauernfeind, Robert A.

AU - Swiryn, Steven

AU - Strasberg, Boris

AU - Palileo, Edwin V.

N1 - Funding Information: Atria1 extrastimulus testing is a variety of programmed stimulation that can be used for evaluation of AV nodal function. The technique consists of delivering timed atria1 premature stimuli, after a series of driven beats, at decrementally decreasing coupling intervals. This allows the generation of an AV nodal function curve in which output (of the AV node) (H,-H, responses) are plotted as a function of input (A,-A, coupling intervals). In most patients, atria1 extrastimulus testing generates a continuous AV nodal conduction curve, suggesting a single AV node with one AV nodal pathway.’ In approximately 10% of electrophysiologic studies, the AV nodal conduction curve is discontinuous (Fig. 1).2 The discontinuity reflects a sudden increase in H,-H,, with a very small decrement in A,-A, coupling intervals. After the discontinuity, a second continuous curve is thus generated. The most reasonable hypothesis explaining the generation of a discontinuous curve is to postulate longitudinal disassociation of the AV node into two pathways (fast and slow).” As noted above, the demonstration of antegrade dual AV nodal pathways is relatively common. Although often demonstrated in patients without any evidence of organic heart disease, there is an association of dual AV nodal pathways with both congenital and acquired heart disease. AV nodal reentry. The clinical relevance of dual AV nodal pathways relates to the close association between this electrophysiologic finding and the occurrence of paroxysmal supraventricular tachycardia (PSVT).” Approximately 70% of patients with recurrent PSVT have dual pathway AV nodal reen- From the Section of Cardiology, Department of Medicine, Abraham Lincoln School of Medicine, University of Illinois College of Medicine. Supported in part by NIH grants 18794,23566, and Institutional Training Grant 07387, and also from a grant by the Eleanor B. Pillsbury Foundation. Received for publication Feb. 2, 1981; accepted Feb. 9, 1981. Reprint requests: Kenneth M. Rosen, M.D., Section of Cardiology, University of Illinois, P.O. Box 6998, Chicago, IL 60680.

PY - 1981/5

Y1 - 1981/5

UR - http://www.scopus.com/inward/record.url?scp=0019462062&partnerID=8YFLogxK

U2 - 10.1016/0002-8703(81)90249-0

DO - 10.1016/0002-8703(81)90249-0

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AN - SCOPUS:0019462062

SN - 0002-8703

VL - 101

SP - 691

EP - 695

JO - American Heart Journal

JF - American Heart Journal

IS - 5

ER -