Retrograde dual atrioventricular nodal pathways

Boris Strasberg*, Steven Swiryn, Robert Bauernfeind, Edwin Palileo, Daniel Scagliotti, C. Elise Duffy, Kenneth M. Rosen

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

25 Scopus citations


Thirty-one (3.5 percent) of 887 studied patients had retrograde dual atrioventricular (A-V) nodal pathways, as manifested by discontinuous retrograde A-V nodal conduction curves (29 patients) or by two sets of ventriculoatrial (V-A) conduction intervals at the same paced cycle length (2 patients). All patients had A-V nodal reentrant ventricular echoes of the unusual variety induced with ventricular stimulation (25 patients had single, 2 patients had double and 4 patients had more than three ventricular echoes). The weak link of the reentrant circuit was always the retrograde slow pathway. Eleven of the 31 patients also had anterograde dual A-V nodal pathways (bidirectional dual pathways). Eight patients (26 percent) had spontaneous as well as inducible A-V nodal reentrant paroxysmal supraventricular tachycardia (of the unusual type in three and the usual type in five). In addition, three patients (10 percent) had only inducible supraventricular tachycardia (two of the unusual and one of the usual type). Retrograde dual A-V nodal pathways are uncommon. They are associated with the finding of at least single A-V nodal reentrant ventricular echoes (all patients), anterograde dual pathways (one third of patients) and A-V nodal reentrant paroxysmal supraventricular tachycardia of the usual or unusual variety (one third of patients).

Original languageEnglish (US)
Pages (from-to)639-646
Number of pages8
JournalThe American journal of cardiology
Issue number4
StatePublished - Oct 1981
Externally publishedYes

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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