An unusual variety of atrioventricular nodal re entry due to retrograde dual atrioventricular nodal pathways

D. Wu, P. Denes, Y. F. Amat Leon

Research output: Contribution to journalArticlepeer-review

80 Scopus citations

Abstract

Three patients with paroxysmal supraventricular tachycardia (PSVT) had discontinuous ventriculo-atrial conduction curves (V1-V2, A1-A2), suggesting dual A-V nodal pathways. Ventricular echoes occurred simultaneously with sudden increase of V-A interval. These echoes were characterized by retrograde P waves occurring in front of QRS, suggesting utilization of a slow pathway for retrograde conduction and a fast pathway for antegrade conduction. In case one, atropine improved retrograde slow pathway and antegrade fast pathway conduction and made A-V nodal re-entry sustained, resulting in PSVT (with retrograde P in front of the QRS). In cases 2 and 3, atropine markedly shortened retrograde fast pathway refractory period and slightly improved antegrade slow pathway conduction. The discontinuous V1-V2, A1-A2 curves and echoes were no longer demonstrable. However, with improvement of retrograde fast pathway and antegrade slow pathway conduction, A-V nodal re-entrant echoes and PSVT were observed, utilizing the slow pathway for antegrade conduction and the fast pathway for retrograde conduction (P simultaneous with QRS).

Original languageEnglish (US)
Pages (from-to)50-59
Number of pages10
JournalCirculation
Volume56
Issue number1
DOIs
StatePublished - 1977

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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