Document Detail

Conduction time oscillations precede the spontaneous termination of human atrioventricular reciprocating tachycardia.
MedLine Citation:
PMID:  10729839     Owner:  NLM     Status:  MEDLINE    
Prior clinical research indicates that conduction slowing is the primary mechanism leading to the spontaneous termination of reentrant tachycardia in humans. Yet, some experimental models indicate that cycle length oscillations and enhanced conduction are important prerequisites. The role of oscillations in conduction times and enhanced conduction in the spontaneous termination of human reentrant tachycardia has not been adequately investigated. The electrophysiologic features preceding the spontaneous termination of orthodromic atrioventricular (AV) reciprocating tachycardia (RT) were evaluated in 21 patients, each of whom had a sustained (>60 seconds) and a spontaneously terminating (>/=10 beats and </=60 seconds) episode of AVRT during the same electrophysiologic study. Atrio-His, His-ventricular, interventricular, ventriculoatrial and atrial conduction times were measured for each beat of spontaneously terminating AVRT and for paired beats of sustained AVRT. Beats of spontaneously terminating and sustained tachycardia were pooled and Hadi multivariate outlier analysis was used to identify whether significant beat-to-beat alterations in conduction times preceded the spontaneous termination of reentry. Cycle lengths of sustained (348+/-62 msec) and spontaneously terminating AVRT (351+/-70 msec) were similar. Significant beat-to-beat oscillations in conduction times preceded the spontaneous termination of AVRT in 10 of the 21 (48%) patients. An apparent enhancement in atrio-His or ventriculoatrial conduction times immediately preceded the spontaneous termination of AVRT in 11 patients (52%), while an apparent conduction delay occurred in only 2 patients (10%). Moreover, significant oscillations in conduction times were present in 9 of the 11 patients (82%) with enhanced conduction, but only in 1 of the 10 (10%) remaining patients (p=0.002. Conduction time oscillations, which are related to apparent enhancement in atrio-His or ventriculoatrial conduction, frequently precede the spontaneous termination of reentry in humans.
D V Exner; L B Mitchell; D G Wyse; R S Sheldon; A M Gillis; P Cassidy; H J Duff
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of interventional cardiac electrophysiology : an international journal of arrhythmias and pacing     Volume:  4     ISSN:  1383-875X     ISO Abbreviation:  J Interv Card Electrophysiol     Publication Date:  2000 Apr 
Date Detail:
Created Date:  2000-06-13     Completed Date:  2000-06-13     Revised Date:  2009-11-03    
Medline Journal Info:
Nlm Unique ID:  9708966     Medline TA:  J Interv Card Electrophysiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  231-9     Citation Subset:  IM    
Department of Medicine, Division of Cardiology, University of Calgary, Canada.
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MeSH Terms
Heart Conduction System / physiopathology*
Middle Aged
Tachycardia, Atrioventricular Nodal Reentry / physiopathology*
Tachycardia, Paroxysmal / physiopathology*

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