TY - JOUR
T1 - Isorhythmic dissociation - A "physiological" arrhythmia
AU - Kaplinsky, Elieser
AU - Aronson, Raymond
AU - Neufeld, Henry N.
PY - 1977
Y1 - 1977
N2 - The behavior of the sino-atrial mechanismin isorhythmic dissociation (IRD) was studied in 21 patients, nine with spontaneous IRD and 12 with artificially pacemaker-induced IRD following electrode placement for heart block. Successive P-P, R-R and P-R intervals and blood pressure (BP) fluctuations were determined and graphically interrelated at control and during IRD. Several features were observed: a. IRD was present only when the independent ventricular rate was close to the atrial; b. P rate oscillations closely followed the P-R interval-dependent BP fluctuations (mean difference 30 mmHg) during IRD. In cardiogenic shock and in severe hypertension IRD could not be achieved easily; c. While during complete dissociation or during 1:1 A-V conduction the sinus rate was remarkably constant (2-4 beats/min variations), it showed marked oscillations (differences of 6-19, mean 13, beats/min) during IRD. All the data and calculations support the theory that in most instances of IRD, the arrhythmia is sustained by the normal physiologically active baroreceptor reflex arc.
AB - The behavior of the sino-atrial mechanismin isorhythmic dissociation (IRD) was studied in 21 patients, nine with spontaneous IRD and 12 with artificially pacemaker-induced IRD following electrode placement for heart block. Successive P-P, R-R and P-R intervals and blood pressure (BP) fluctuations were determined and graphically interrelated at control and during IRD. Several features were observed: a. IRD was present only when the independent ventricular rate was close to the atrial; b. P rate oscillations closely followed the P-R interval-dependent BP fluctuations (mean difference 30 mmHg) during IRD. In cardiogenic shock and in severe hypertension IRD could not be achieved easily; c. While during complete dissociation or during 1:1 A-V conduction the sinus rate was remarkably constant (2-4 beats/min variations), it showed marked oscillations (differences of 6-19, mean 13, beats/min) during IRD. All the data and calculations support the theory that in most instances of IRD, the arrhythmia is sustained by the normal physiologically active baroreceptor reflex arc.
UR - http://www.scopus.com/inward/record.url?scp=0017345989&partnerID=8YFLogxK
U2 - 10.1016/S0022-0736(77)80052-6
DO - 10.1016/S0022-0736(77)80052-6
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AN - SCOPUS:0017345989
VL - 10
SP - 179
EP - 188
JO - Journal of Electrocardiology
JF - Journal of Electrocardiology
SN - 0022-0736
IS - 2
ER -