Clinical, Electrocardiographic, and Electrophysiological Observations of Dual A-V Nodal Pathways : Cardiac Conduction Disturbances : Structure, Function and Clinical Significance

概要

論文の詳細を見る
In 45 (25%) of 182 patients with various cardiac arrhythmias, dual A-V nodal pathways (DPWs) were diagnosed with atrial extrastimulus technique at least at one or more basic cycle lengths and/or after intravenous administration of atropine (1 mg). The jump of discontinuous A_1A_2 , H_1H_2 curve of these 45 ranged from 25 to 235 (92±56) msec and the jump of A_1A_2 , A_2H_2 curve ranged from 40 to 260 (107±55) msec. The fast pathway FRP (functional refractory period), slow pathway FRP, fast pathway ERP (effective refractory period) and slow pathway ERP was 464±87 msec, 532±91 msec, 404±96 msec and 328±70 msec, respectively. DPWs were demonstrated in 10 (59%) of 17 patients with paroxysmal supraventricular tachycardia (PSVT), 3 (5%) of 55 with WPW syndrome, 2 (20%) of 10 with paroxysmal atrial fibrillation, 11 (29%) of 38 with sick sinus syndrome, 10 (38%) of 26 with first degree and/or second degree A-V (AH) block, none of 3 with second degree HV block, 3 (27%) of 11 with bundle branch block and 6 (27%) of 22 with the other cardiac arrhythmias. In 17 patients with PSVT, seven demonstrated A-V nodal reentrant tachycardia. Six of these 7 had evidence of DPWs. In the other 7 of the 17, concealed accessory pathway was demonstrated. Three of these 7 had DPWs, which did not constitute the reentrant circuit. Twenty-eight of 45 patients (62%) with DPWs had one or more electrophysiological abnormalities suggesting A-V nodal dysfunction: 1) prolonged AH interval (>130 msec) during sinus rhythm (10 patients), 2) atrial pacing rates of 130 or less inducing A-V nodal Wenckebach periods (24 patients), 3) prolonged A-V nodal ERP or slow pathway ERP (>400 msec) (8 patients), and 4) prolonged A-V nodal FRP or fast pathway FRP (>500 msec) ( 16 patients). However, in most patients, atropine improved A-V nodal dysfunction. We consider that DPWs are a common electrophysiological finding and have a strong association not only with PSVT but also with A-V nodal dysfunction.
社団法人日本循環器学会の論文
1981-04-20

Clinical, Electrocardiographic, and Electrophysiological Observations of Dual A-V Nodal Pathways : Cardiac Conduction Disturbances : Structure, Function and Clinical Significance

スポンサーリンク

概要

著者

関連論文

スポンサーリンク