New manifestations of dual A-V nodal pathways

D. Wu, P. Denes, R. Dhingra, R. J. Pietras, K. M. Rosen

Research output: Contribution to journalArticlepeer-review

93 Scopus citations


Electrophysiological studies with extrastimulus technique demonstrated evidence of dual AV pathways in 2 patients with paroxysmal supraventricular tachycardia (PSVT). In case one, the second P of paced Wenckebach sequences was followed by 2 conducted QRS complexes without an intervening P wave. The AH of the first and second QRS were consistent with the fast and slow pathway conduction times. The second QRS was followed by an atrial echo and PSVT, suggesting that the fast pathway was available for retrograde propagation following the second QRS. In case two PSVT was induced with atrial extrastimulus, followed by development of AV dissociation. The 2 cases suggest the following conclusions: dual AV nodal pathways may allow the occurrence of double antegrade conduction of one P; the atria are not necessary for AV nodal circus movements in 'dual pathway' AV nodal reentrant PSVT.

Original languageEnglish (US)
Pages (from-to)459-466
Number of pages8
JournalEuropean Journal of Cardiology
Issue number4
StatePublished - Dec 1 1975

ASJC Scopus subject areas

  • Medicine(all)


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