Two accessory pathways, dual AV nodal conduction, and 1:2 ventriculoatrial conduction in a patient with multiple supraventricular tachycardias.
Multiple supraventricular tachycardias were induced in a patient with two left posterior accessory pathways and dual atrioventricular nodal conduction. One of the accessory pathways conducts slowly and exhibits decremental conduction. A "double retrograde response" (2:1 ventriculoatrial conduction) due to simultaneous retrograde propagation of a single ventricular depolarization over two longitudinally dissociated pathways plays a role not only in tachycardia initiation, but in the maintenance of a unique, irregular tachycardia.
Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut 06510.
L E
LE
Rosenfeld
W P
WP
Batsford
D000328:Adult; D001283:Atrioventricular Node / Q000503:physiopathology*; D002036:Bundle of His / Q000503:physiopathology; D002037:Bundle-Branch Block / Q000503:physiopathology; D002304:Cardiac Pacing, Artificial / Q000379:methods; D004562:Electrocardiography; D005260:Female; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D009431:Neural Conduction; D012032:Refractory Period, Electrophysiological / Q000502:physiology; D012849:Sinoatrial Node / Q000503:physiopathology; D013617:Tachycardia, Supraventricular / Q000503:physiopathology*; D013997:Time Factors; D014927:Wolff-Parkinson-White Syndrome / Q000503:physiopathology