'Supernormal conduction' of a premature impulse utilizing the fast pathway in a patient with dual atrioventricular nodal pathways

P. Denes, C. R C Wyndham, D. Wu, K. M. Rosen

Research output: Contribution to journalArticlepeer-review

8 Scopus citations

Abstract

Electrophysiological studies with the atrial extrastimulus technique suggested the presence of dual atrio vascular (AV) nodal pathways in a patient with hypothyroidism, as evidenced by a sudden increase of H1 H2 intervals at critical A1 A2 coupling intervals. Following the atrial extrastimulus (A2), a third impulse (A3) occurred spontaneously. During slow pathway conduction of A2, an A3 appearing at a critically timed interval allowed fast pathway conduction, resulting in an earlier than expected QRS (a form of supernormal conduction). This demonstration of fast pathway conduction during slow pathway conduction adds strong evidence for the existence of dual AV nodal pathways.

Original languageEnglish (US)
Pages (from-to)811-814
Number of pages4
JournalCirculation
Volume51
Issue number5
DOIs
StatePublished - 1975

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

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