Auricular paroxysmal tachycardia with auriculoventricular block

Barker, Paul S.; Wilson, Frank N.; Johnston, Franklin D.; Wishart, Shelby W.

doi:10.1016/s0002-8703(43)90679-9

Cited by 49 publications

(8 citation statements)

References 13 publications

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“…The close relationship of auricular rhythm to repetitive paroxysmal tachycardia is shown by our Case 12 (vide Fig. 1 (C) in Barker et al 1943), and the one of Maddox (1937); in both of them an ectopic P identical with the one during paroxysms continued when the paroxysms were over and the rate was slow. Normal sinus rhythm was not seen.…”

Section: The Nature Of the Conditionsupporting

confidence: 71%

“…This group which included their only patient with no organic heart disease carried a less serious prognosis than the other group with persistent ventricular tachycardia. In Cooke and White's (1943) list of 32 cases of ventricular paroxysmal tachycardia, Cases 24, 25, and 27, and Freundlich's (1946) Case 3, probably belong to this variety, and so do several of Barker, Wilson, and Wishart's (1943) cases; their Case 1 is our Case 12, and Campbell's (1945) Case 2 is our Case 2.…”

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confidence: 92%

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Repetitive Paroxysmal Tachycardia

Parkinson¹,

Papp²

1947

Heart

138

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Paroxysmal tachycardia might be defined as sudden attacks of extreme acceleration of the heart that last from a few seconds to a few days and end abruptly as they begin. In the average patient with paroxysmal tachycatdia the paroxysm is the exception: normal rhythm is the rule; the difficulty is to obtain an electrocardiogram during the attack. We have become interested in a special variety where recurrent paroxysms are the rule and normal rhythm is the exception; the difficulty now is to obtain the normal electrocardiogram. This variety is here described as repetitive. It is characterized by recurring short runs of auricular, nodal, or ventricular extrasystoles, runs or paroxysms of tachycardia in fact, almost constantly present for months or for years and only occasionally interrupted by the normal sinus rhythm. We do not include under this term the recurrent brief paroxysms of tachycardia which may happen to be portrayed on an isolated electrocardiogram. It is true that in a sense they are repetitive, but this is an incident, not a clinical state like that of repetitive paroxysmal tachycardia where the play of paroxysms almost displaces normal rhythm. Its separate consideration is justified on clinical grounds; for it more often affects children and young people in whom it presents a novel problem in prognosis. There are few conditions in children of which it can be said that they are likely to " grow out of it," but this appears to be one.It is 20 years since one of us (J. P.) came across our Case 1, and since then we have records, more or less complete, of 40 cases of repetitive paroxysmal tachycardia. Cases to be quoted below have been reported singly or perhaps in twos or threes. Our plan was to place on record for the first time a large group of such cases. We have since found, however, in the monograph of Leon Gallavardin (1946), a study of this nature under the title " Extrasystolie auriculaire en salves," differing from ours in that it relates to auricular paroxysms only. Lewis (1909) made the first observation of this kind in a man of 41 with an otherwise healthy heart. By continuous polygraphic record during 109 minutes he was able to count 54 short paroxysms of auricular paroxysmal tachycardia at a rate of 133-184. Paroxysms of over 1 minute duration were rare; the shortest attack consisted of a succession of a few ectopic beats, the longest lasted 7 minutes. Though occurring at rest, they were more frequent on exertion. Even at a slow rate the pulse was hardly ever regular because of single or multiple auricular extrasystoles. White (1920) drew attention to the " markedly rapid but not immediate " increase in rate and similar offset during the short and continuously recurring attacks of auricular paroxysmal tachycardia in his patient observed for five years. Scott (1922) abolished with quinidine the short and continuously recurring attacks of ventricular tachycardia which were precipitated by exertion and were the cause of serious invalidism in this patient.Louis Gallavardin (1922, a, b, and c)...

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Section: The Nature Of the Conditionsupporting

confidence: 71%

mentioning

confidence: 92%

Repetitive Paroxysmal Tachycardia

Parkinson¹,

Papp²

1947

Heart

138

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“…In contrast. 1 patient without organic heart disease died of cardiac failure attributable entirely to 84 days of atrial tachycardia at a rate of 129-167 beats/min with 1:1 to 3:2 AV block [4], To the best of our knowledge, intra-atrial reentrant tachycardia with AV block has not been previously de scribed by electrophysiological study in patients without structural heart diseases or taking any medication. We conclude that atrial tachycardia with AV block can occur in patients without structural heart diseases or being exposed to any medication provided that the atrial tachy cardia cycle length is shorter than the Wenckebach period of the AV node.…”

Section: Discussionmentioning

confidence: 87%

“…He attributed the cause for AV block to defective conduction in the AV bundle and its branches. Barker et al [4] called attention to auricular tachycardia with AV block by collecting 17 previous reports and adding 18 of their own. Of these 35 patients.…”

Section: Discussionmentioning

confidence: 99%

“…Elucidation of the tachycardia mechanisms is important clinically because each presents with different pathophysiology and re sponses to specific pharmacological therapies. Intra-atrial reentrant tachycardia has been shown to be frequently associated with underlying structural heart disease [1.2], Furthermore, the majority of the cases of paroxysmal atrial tachycardia with atrioventricular (AV) nodal block are either caused by digitalis intoxication or serious heart disease [2][3][4][5][6][7], The present report describes a paroxysmal atrial tachycardia with AV nodal block in a patient with out structural heart disease or taking any medication. The mechanism of the atrial tachycardia and AV block is well defined by electrophysiological study.…”

Section: Introductionmentioning

confidence: 99%

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Paroxysmal Atrial Tachycardia with Second-Degree Atrioventricular Block

Chen

Guo²,

Chang³

1997

Cardiology

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Paroxysmal atrial tachycardia with atrioventricular block usually indicates potentially dangerous overdigitalization, and serious heart disease is almost universally present. In this report, we describe a patient with a structurally normal heart who manifested spontaneously intra-atrial reentrant tachycardia with Wenckebach atrioventricular block in the absence of medications. In this patient, the longest atrial paced cycle length that induced atrioventricular nodal block was 390 ms, and the atrial cycle length during tachycardia ranged from 360 to 400 ms. The electrophysiologic study in our patient demonstrated that second-degree atrioventricular block during atrial tachycardia may occur in patients without structural heart diseases or taking any medication.

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Diseases of the Heart

Williams¹

1944

Arch Intern Med (Chic)

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Auricular paroxysmal tachycardia with auriculoventricular block

Cited by 49 publications

References 13 publications

Repetitive Paroxysmal Tachycardia

Repetitive Paroxysmal Tachycardia

Paroxysmal Atrial Tachycardia with Second-Degree Atrioventricular Block

Diseases of the Heart

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