Chronic auricular tachycardia with unusual response to change in posture

Miller, Ralph; Perelman, Julius S

doi:10.1016/0002-8703(45)90546-1

Cited by 23 publications

(5 citation statements)

References 11 publications

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“…Since that time clinical reports of atrial rhythms, including single extrasystoles, persistent rhythms of moderate rate, and rapid tachyarrhythmias have been reported to originate in areas of the left atrium (14)(15)(16)(17)(18)(19). The clinical occurrence of these left atrial rhythms is deemed to be rare on the basis of electrocardiographic criteria.…”

Section: Discussionmentioning

confidence: 99%

Electrophysiological Properties of Cardiac Muscle in the Anterior Mitral Valve Leaflet and the Adjacent Atrium in the Dog

Wit

Fenoglio

Wagner

et al. 1973

Circulation Research

129

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Transmembrane action potentials were recorded from multiple sites in isolated canine anteromedial left atrial wall preparations with the anterior mitral valve leaflet attached. The preparations were superfused with Tyrode's solution. When the left atrial wall was electrically stimulated, activity propagated into the mitral valve leaflet. Typical atrial action potentials occurred in atrial wall fibers. However, maximum diastolic potential, total action potential amplitude, and rate of depolarization decreased markedly in the atrium overlying the fibrous annulus (junctional region), and repolarization characteristics were altered in this region. Mitral valve muscle fibers demonstrated still lower maximum diastolic potential, action potential amplitude, and rate of depolarization. Electrical excitation of single discrete regions in the mitral valve leaflet did not result in conduction to the atrium; conduction block occurred in the junctional region. However, simultaneous excitation of several mitral valve sites did cause an impulse to propagate to the atrium, but transmembrane action potentials of junctional fibers were characteristically different from those recorded from the same junctional fibers during activation from the atrium. Muscle fibers in the mitral valve leaflet were capable of developing spontaneous diastolic depolarization, which resulted in automatic impulse initiation, when they were exposed to epinephrine or norepinephrine (1 X l(h 7 to 1 X 10-*M) or when they were stretched. Spontaneous diastolic depolarization and automaticity also occurred occasionally without pharmacological or other experimental interventions; moreover, spontaneous activity originating in the mitral valve leaflet could propagate into and activate the atrial wall. Acetylcholine abolished spontaneous activity. These data suggest that the mitral valve could act as a site of ectopic impulse initiation in the left atrium.

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Section: Discussionmentioning

confidence: 99%

Electrophysiological Properties of Cardiac Muscle in the Anterior Mitral Valve Leaflet and the Adjacent Atrium in the Dog

Wit

Fenoglio

Wagner

et al. 1973

Circulation Research

129

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“…3 Our search of the literature has uncovered only 20 reports of patients with the persistent type of chronic atrial tachycardia." [3][4][5][6][7][8][9][10][11][12] Furthermore, the mechanism of this arrhythmia is unknown and there are no reports of any electrophysiologic studies in these patients. Goldreyer et al`3 studied three patients with episodic bouts of atrial tachycardia by both atrial overdrive pacing and induced coupled atrial premature beats and summarized the evidence supporting an ectopic atrial focus as the mechanism of the arrhythmia.…”

Section: Additional Indexing Wordsmentioning

confidence: 99%

Electrophysiologic Studies in Patients with Persistent Atrial Tachycardia

1974

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Clinical and electrophysiologic studies in two patients with chronic persistent atrial tachycardia unresponsive to drug or electroconversion therapy are reported. In both, exercise increased the atrial rate and decreased the atrioventricular nodal conduction time. The opposite effect occurred after f3-adrenergic blockade. Single electrically-induced atrial depolarizations (A2) at progressively premature times resulted in a linear increase in the return cycle (A2A3) until plateau levels were achieved but failed to produce sinus rhythm. Abrupt cessation of continuous atrial pacing at rates up to 600 beats/min in one patient and up to 300 beats/min in the other resulted in a pause that was similar to the plateau levels of A2A3 achieved during atrial scanning with single impulses. Our findings suggest that an ectopic atrial focus is responsible for this arrhythmia. The electrophysiologic properties of the ectopic pacemaker appear to be similar to the sinoatrial node in some respects but to differ in terms of spontaneous rate and in relative immunity from the effects of overdrive pacing.

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“…There is now a considerable literature on the induction of tachycardia on inspiration [3, 6, 14, 32. 41. p. 160], hyperventilation [65], exercise [16,56] change in position [7,8,11,40,49] or swallowing [25, p. 167, 29]. In 1912 Kure [30] described a 12-year-old Japanese schoolgirl who would develop paroxysms of tachy cardia, as demonstrated polygraphically, whenever she tackled an arith metical problem.…”

Section: Relationship To Nervous Phenomenamentioning

confidence: 99%

Repetitive Paroxysmal Tachycardia in Adults

Levine¹,

Smith²

1970

Cardiology

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A uniform characterization applying to all patients with repetitive tachycardia, or status tachycardiacus, is hardly justifiable. This group of patients is heterogeneous in morphology, in prognostic implication and in management. It is in childhood and youth that the essence of this disorder seems to manifest itself, undiluted by admixture with various conditions incidental to the aging process. But repetitive tachycardia as observed in adults is not quite the same condition. Here it is not necessarily benign; it is commonly associated with organic heart disease, occasionally in its terminal phase. And it is difficult if not impossible to separate those effects that are due to repetitive paroxysmal tachycardia from those due to complicating disease. Repetitive tachycardia is frequently observed in neurotic patients, Repetitiveness may develop as a phase in patients with a long-standing history of classical tachycardia. Prophylaxis is very much on a trial-and-error basis; occasionally it seems successful but more often all measures are only partially or temporarily effective.

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Chronic auricular tachycardia with unusual response to change in posture

Cited by 23 publications

References 11 publications

Electrophysiological Properties of Cardiac Muscle in the Anterior Mitral Valve Leaflet and the Adjacent Atrium in the Dog

Electrophysiological Properties of Cardiac Muscle in the Anterior Mitral Valve Leaflet and the Adjacent Atrium in the Dog

Electrophysiologic Studies in Patients with Persistent Atrial Tachycardia

Repetitive Paroxysmal Tachycardia in Adults

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