Document Detail

Concealed nonparoxysmal junctional tachycardia.
MedLine Citation:
PMID:  455629     Owner:  NLM     Status:  MEDLINE    
Electrophysiologic studies were performed in a patient who had an apparently uncomplicated complete trifascicular block. His bundle recordings revealed atrioventricular dissociation with: 1) an atrial rate of 58 beats/min, 2) an idioventricular escape rate of 45 beats/min, and 3) nonparoxysmal junctional tachycardia (His bundle rhythm) at a rate of 65--85 beats/min. The latter arrhythmia was electrocardiographically silent, influencing neither atrial nor ventricular events. The arrhythmia probably reflected digitalis intoxication (digoxin level of 3.3 ng/ml). A repeat electrophysiologic study 4 days after digoxin was discontinued revealed complete trifascicular block (distal to H) with intact conduction between the atrium and the His bundle (AH of 150 msec). Thus, electrophysiologic study demonstrated an electrocardiographically silent but clinically relevant arrhythmia, suggesting that His bundle recording should be part of diagnostic study during temporary pacemaker implantation in patients with atrioventricular block.
C R Wyndham; R C Dhingra; T Smith; D Best; K M Rosen
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  60     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1979 Sep 
Date Detail:
Created Date:  1979-09-27     Completed Date:  1979-09-27     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  707-10     Citation Subset:  AIM; IM    
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MeSH Terms
Bundle of His / physiopathology
Heart Block / complications
Tachycardia, Paroxysmal / complications,  diagnosis*

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

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