title: AV dissociation, an inevitable response.
abstract: BACKGROUND
  The independent activation of the atria and ventricles, AV dissociation, is a common phenomenon that occurs during a wide variety of electrophysiologic circumstances. The clinical significance of AV dissociation is often misunderstood.
  
  
  METHODS
  This article examines the basis and clinical implications of AV dissociation.
  
  
  RESULTS
  AV dissociation is often an obligatory, secondary phenomenon, and should not be construed as the primary disorder; it may be due to either the AV conduction system being completely blocked (3° AV block) or the P wave and the QRS complex being generated from separate sources (usually, the AV junction or ventricle) but occurring close together during the physiologic refractory period of each other. The latter may happen in junctional or ventricular arrhythmias including escape or accelerated rhythm, tachycardia, or premature beats.
  
  
  CONCLUSIONS
  The crucial clinical point is not the AV dissociation itself, but that an underlying triggering primary disorder is present and should be identified.
authors.affiliation: Cardiovascular Division, Department of Medicine, University of Minnesota Medical School, Minneapolis, MN, USA.
authors.forename: Kyuhyun
authors.initials: K
authors.lastname: Wang
authors.forename: David G
authors.initials: DG
authors.lastname: Benditt
mesh_terms: D054537:Atrioventricular Block / Q000503:physiopathology; D001283:Atrioventricular Node / Q000503:physiopathology*; D002304:Cardiac Pacing, Artificial; D015716:Electrocardiography, Ambulatory; D006325:Heart Atria / Q000503:physiopathology*; D006352:Heart Ventricles / Q000503:physiopathology*; D006801:Humans