Double Ventricular Response to an Extrastimulus in a Patient with Triple Atrioventricular Pathways

Pimenta, João; Miranda, Manoel; Silva, Lélio A

doi:10.1378/chest.74.5.593

Cited by 13 publications

(1 citation statement)

References 4 publications

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“…An E 1 :E 2 ratio of > 1:1 is counterintuitively also compatible with E 2 “driving” E 1 , but this will require “longitudinal” dissociation in the conduction path (in the sense that ≥ 2 pathways operate in parallel) between E 1 and E 2 . An example of this phenomenon is a single atrial complex giving rise to two ventricular complexes in the presence of an AP, 16 dual AVN physiology (Fig. 2) 17 or longitudinal dissociation in the His bundle 18,19 …”

Section: Electrical Association and Dissociationmentioning

confidence: 99%

Infraatrial Supraventricular Tachycardias: Mechanisms, Diagnosis, and Management

Lau

2008

Pacing Clinical Electrophis

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Tachycardias are traditionally classified as either ventricular tachycardia (VT) or supraventricular tachycardia (SVT). VT can be defined as a tachycardia which requires only ventricular structures for perpetuation. SVT is defined in terms of exclusion of VT and hence is any tachycardia which requires participation of at least one supraventricular structure for perpetuation. Certain SVTs require only participation of the atrioventricular node (AVN) and the His bundle (HB) but not the atrial myocardium or any of the great thoracic veins for perpetuation and hence can be described as "infraatrial." The three main mechanisms of infraatrial SVTs are: (1) intranodal atrioventricular reentrant tachycardia; (2) junctional ectopic tachycardia; and (3) nodoventricular reentrant tachycardia. The clinical significance of infraatrial SVTs is that they are compatible with any A:V ratio and even atrioventricular (AV) dissociation. Infraatrial SVTs are often suspected when a narrow complex tachycardia presents with apparent AV dissociation and a counterintuitive A:V ratio of < 1:1. However, if the same tachycardia is conducted with aberrant conduction or preexcitation, a broad complex tachycardia with an A:V ratio of < 1:1 will arise and that can be easily mistaken for VT. The possible patterns of electrical association and dissociation between different cardiac structures are examined, and how individual types of infraatrial SVT can be diagnosed and managed are reviewed.

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Section: Electrical Association and Dissociationmentioning

confidence: 99%