Dual atrioventricular nodal pathways associated with a gap phenomenon in atrioventricular nodal conduction

A 67 year old man underwent electrophysiologic study for evaluation of syncope. During atrial pacing at a basic cycle length of 600 ms, atrial premature stimuli were introduced at progressively shorter coupling intervals. The graph of atrial coupling intervals versus corresponding His bundle respons...

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Bibliographic Details
Published in:Journal of the American College of Cardiology 1983-09, Vol.2 (3), p.582-584
Main Authors: Brodine, William N., Lyons, Chalmers, Han, Jaok
Format: Article
Language:English
Subjects:
Aged
Atrioventricular Node - physiopathology
Cardiac Complexes, Premature - diagnosis
Cardiac Pacing, Artificial
Electrophysiology
Heart Conduction System - physiopathology
Humans
Male
Syncope - diagnosis
Syncope - etiology
Time Factors
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Summary:A 67 year old man underwent electrophysiologic study for evaluation of syncope. During atrial pacing at a basic cycle length of 600 ms, atrial premature stimuli were introduced at progressively shorter coupling intervals. The graph of atrial coupling intervals versus corresponding His bundle responses revealed an abrupt increase in atrioventricular (AV) nodal conduction time with coupling intervals from 320 to 340 ms. In an atrial coupling interval of less than 320 ms, conduction was again rapid until the effective refractory period of the atrium was reached. These unique findings are compatible with dual pathways and a gap phenomenon within the AV node.
ISSN:0735-1097
1558-3597
DOI:10.1016/S0735-1097(83)80289-7