Differential Diagnosis Between Dual Ventricular Response and Bigeminy Arising From the Bundle of His

His Bundle Extrasystole or A Dual Atrioventricular Nodal Response

“…Although in the case that His extrasystoles originate from the proximal His, the His bundle activation is sequential from proximal to distal as in 1:2 AV conduction, if the extrasystole originates from the distal part, the reverse activation of His can differentiate it from the other condition. Absence of the atrial-His bundle jump during atrial extra-stimulation is also in favor of extrasystole [2,3]. During our study, we found some other beats with different conduction patterns.…”

A case of dual atrioventricular nodal nonreentrant tachycardia: An unusual cause of tachycardia‐induced cardiomyopathy

“…In our patient, there were some clues that ruled out Hisian extrasystoles. Retrograde His activation (i.e., activation of the proximal His after the distal His) and shortening of the HV interval are indicative of parahisian extrasystole [3]. However, in our case, His was activated antegradely with an equal HV interval compared to the sinus rhythm ( Fig.…”

“Atrial Fibrillation and Premature Ventricular Complexes” – is there a unifying diagnosis?

“…Although it was difficult to definitively exclude junctional extrasystoles as an alternative explanation for the extrasystoles, retrograde His activation with shortening of the HV interval is often described with junctional extrasystoles. 1 In our case, the His activation was always proximal to distal and the HV interval was unchanged compared to that during sinus rhythm. Also, the coupling interval of the extrasystolic beat appeared consistent with both decremental atrial pacing and atrial extra-stimuli (Figure 3B).…”