Atrial Pacing-Induced Reverse Alternating Wenckebach Periods : A Common Electrophysiologic Phenomenon in Patients with Dual Atrioventricular Nodal Pathways
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概要
- 論文の詳細を見る
Reverse alternating Wenckebach periods (RAWP) have rarely been described, and the significance of dual AV nodal pathways in atrial pacing-induced RAWP is unknown. Forty-five of 50 consecutive patients (M/F=23/27, mean age 40±5 years) with common type AV nodal reentrant tachycardia had discontinuous antegrade conduction curves. Atrial pacing revealed that pattern A RAWP (23 patients) had the fourth paced beat conducted over the fast pathway, and pattern B (18 patients) over the slow pathway. Four patients had both pattern A and B RAWP during different pacing cycle lengths. All episodes of atrial pacing-induced RAWP emerged from (or started as) 3:2 AH block, which thereafter were followed by runs of 2:1 AH block. Comparisons between patterns A and B showed (1) maximal atrial pacing cycle length with RAWP was longer in pattern A; (2) A2H2-A1H1 and A4H4-A1H1 were significantly greater in pattern B; (3) A2H2-A4H4 and H2A4/A2H2 were significantly greater in pattern A.It is concluded that atrial pacing-induced RAWP is a common electrophysiologic phenomenon in patients with dual AV nodal pathways. Furthermore, intermittent slow pathway conduction associated with different AnHn and HnAn+2 parameters helped the interpretation of different conduction patterns.
著者
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Chen Shih-ann
Division Of Cardiology Department Of Medicine And National Yang-ming University School Of Medicine A
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Cheng Chen-chuan
Division Of Cardiology Chi-mei Medical Center
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WANG Shih-Pu
Division of Cardiology, Department of Medicine, Veterans General Hospital
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CHANG Mau-Song
Division of Cardiology, Department of Medicine, Veterans General Hospital
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Chiang Chern-en
Division Of Cardiology Department Of Medicine Taipei Veterans General Hospital And National Yang-min
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CHIANG Benjamin
Division of Cardiology, Department of Medicine, Veterans General Hospital-Taipei
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CHIANG Chern-En
Division of Cardiology, Department of Medicine, Veterans General Hospital-Taipei
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CHIANG Benjamin
Division of Cardiology, Department of Medicine, National Yang-Ming Medical College, Taipei and Veterans General Hospital-Taipei
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WU Tsu
Division of Cardiology, Department of Medicine, Veterans General Hospital-Taipei
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YANG Chin
Division of Cardiology, Department of Medicine, Veterans General Hospital-Taipei
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Wu Tsu
Division of Cardiology, Department of Medicine, National Yang-Ming University, School of Medicine and Veterans General Hospital-Taipei and Kaohsiung
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CHIANG Benjamin
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital and the National Yang Ming Medical College
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CHANG Mau-Song
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital-Kaohsiung and Taipei
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CHENG Chen-Chuan
Division of Cardiology, Department of Medicine, Veterans General Hospital-Taipei
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Chen Shih-Ann
Division of Cardiology and Cardiovascular Research Center, National Yang-Ming University, School of Medicine, and Taipei Veterans General Hospital, Taipei Municipal Gan-Dau Hospital
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WANG Shih-Pu
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital and the National Yang Ming Medical College
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CHEN Shih-Ann
Division of Cardiology, Department of Medicine, Veterans General Hospital-Taipei
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CHANG Mau-Song
Division of Cardiology, Department of Internal Medicine, Veterans General Hospital and the National Yang Ming Medical College
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WANG Shih-Pu
Division of Cardiology, Department of Medicine, Veterans General Hospital-Taipei
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