Document Detail


2:1 atrioventricular block during atrioventricular node reentrant tachycardia.
MedLine Citation:
PMID:  8962565     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The purpose of this study was to determine the incidence and to clarify the mechanism of 2:1 atrioventricular (AV) block during AV node reentrant tachycardia induced in the electrophysiology laboratory. BACKGROUND: In patients with 2:1 AV block during AV node reentrant tachycardia, the absence of a His bundle potential in the blocked beats has been considered evidence of intranodal, lower common pathway block. METHODS: In consecutive patients with AV node reentrant tachycardia, the incidence of 2:1 AV block and the response to atropine and a single ventricular extrastimulus was observed. RESULTS: Persistent 2:1 AV block occurred in 13 of 139 patients with AV node reentrant tachycardia. A His bundle deflection was present in the blocked beats in eight patients and absent in five. Patients with 2:1 AV block had a shorter tachycardia cycle length than did patients without such block (mean +/- SD 312 +/- 32 vs. 353 +/- 55 ms, p < 0.01). Atropine did not alter the 2:1 block in any patient. In every patient, a single ventricular extrastimulus introduced during the tachycardia converted the 2:1 block to 1:1 conduction. CONCLUSIONS: The incidence of induced 2:1 AV block during AV node reentrant tachycardia is approximately 10%. The lack of a response to atropine and the consistent conversion of 2:1 block to 1:1 conduction by a ventricular extrastimulus indicate that, regardless of the presence or absence of a His bundle potential in blocked beats, 2:1 block during AV node reentrant tachycardia is due to functional infranodal block.
Authors:
K C Man; K Brinkman; F Bogun; B Knight; M Bahu; R Weiss; R Goyal; M Harvey; E G Daoud; S A Strickberger; F Morady
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of the American College of Cardiology     Volume:  28     ISSN:  0735-1097     ISO Abbreviation:  J. Am. Coll. Cardiol.     Publication Date:  1996 Dec 
Date Detail:
Created Date:  1997-01-16     Completed Date:  1997-01-16     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1770-4     Citation Subset:  AIM; IM    
Affiliation:
Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0022, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Anti-Arrhythmia Agents / pharmacology
Atropine / pharmacology
Bundle of His / physiopathology
Cardiac Pacing, Artificial
Electrocardiography
Female
Heart Block / etiology*,  physiopathology
Humans
Male
Middle Aged
Prospective Studies
Tachycardia, Atrioventricular Nodal Reentry / complications*,  physiopathology
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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