Document Detail

Doubling of the ventricular rate by interpolated junctional extrasystoles resembling supraventricular tachycardia.
MedLine Citation:
PMID:  20497352     Owner:  NLM     Status:  MEDLINE    
In a study of seven cases of paroxysmal supraventricular tachycardia, it was noted that the fast rate was not caused by the mechanism of rapid firing, reentry, or dual atrioventricular nodal conduction but by an abrupt doubling of the rate by interpolation of junctional extrasystoles between adjacent sinus beats while the sinus mechanism remained undisturbed. Dual ventricular response to a single atrial depolarization was seriously considered in each case. The intervals separating the junctional extrasystoles tended to be quite fixed, thus conforming to the pattern of junctional parasystole with an intrinsic rate very close to the rate of the dominant sinus rhythm. The paroxysms of tachycardia were transient, lasting a few seconds to 3.5 minutes. The onset and termination of the paroxysms were completely unpredictable and appeared unrelated to any change in the basic sinus rate or other identifiable mechanism. In only one case, case 7, the concept of dual ventricular response appeared tenable. However, as will be discussed later, the mechanism of junctional parasystole was found to be physiologically more acceptable.
Rashid Massumi; Michael Shehata
Publication Detail:
Type:  Journal Article     Date:  2010-05-21
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 Aug 
Date Detail:
Created Date:  2010-08-13     Completed Date:  2010-12-06     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  945-9     Citation Subset:  IM    
Cedars Sinai Heart Institute, Los Angeles, California, USA.
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MeSH Terms
Cardiac Complexes, Premature / physiopathology*
Heart Rate*
Middle Aged
Tachycardia, Paroxysmal / physiopathology*
Tachycardia, Supraventricular / physiopathology*
Ventricular Function*
Young Adult

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