title: Longitudinal dissociation in the his bundle: a possible mechanism of two distinct cycle lengths in atrioventricular reentrant tachycardia.
abstract: Two wide QRS tachycardias with identical morphology but different cycle lengths (CLs) developed in a 63-year-old man. Electrophysiological study demonstrated inducible atrioventricular reentrant tachycardia (AVRT) due to a concealed left posterior accessory pathway (AP), which was successfully ablated by radiofrequency application. Neither dual AV nodal pathways nor other APs were documented. Splitting of the His-bundle electrogram was shown, and programmed stimulation induced sudden prolongation of intra-hisian conduction time. These results suggest longitudinal dissociation in the His bundle may be responsible for two distinct CLs in AVRT without dual AV nodal physiology.
authors.affiliation: Department of Cardiology, Yokosuka Kyosai General Hospital, Japan.
authors.forename: J
authors.initials: J
authors.lastname: Akiyama
authors.forename: K
authors.initials: K
authors.lastname: Aonuma
authors.forename: S
authors.initials: S
authors.lastname: Ogahara
authors.forename: Y
authors.initials: Y
authors.lastname: Okamoto
authors.forename: S
authors.initials: S
authors.lastname: Umezawa
authors.forename: M
authors.initials: M
authors.lastname: Inada
authors.forename: M
authors.initials: M
authors.lastname: Korenaga
authors.forename: A
authors.initials: A
authors.lastname: Nogami
authors.forename: M
authors.initials: M
authors.lastname: Hiroe
authors.forename: F
authors.initials: F
authors.lastname: Marumo
authors.forename: Y
authors.initials: Y
authors.lastname: Iesaka
mesh_terms: D002036:Bundle of His / Q000503:physiopathology*; D017115:Catheter Ablation; D006801:Humans; D008297:Male; D008875:Middle Aged; D013611:Tachycardia, Atrioventricular Nodal Reentry / Q000503:physiopathology* / Q000628:therapy