Document Detail


Intra His Purkinje gap phenomenon during retrograde conduction in man.
MedLine Citation:
PMID:  7205107     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Ventricular refractory period studies were performed in 24 patients using the ventricular extrastimulus (V2) method at a basic ventricular drive (V1V1). Gap phenomenon confined to the His-Purkinje system (V-H gap) during retrograde conduction was observed in six of 24 patients. In this form of gap, the premature impulse (V2) is initially blocked in the His-Purkinje system (HPS) as recognized by the absence of retrograde His bundle deflection (H2) and atrial depolarization (A2) following V2. At closer V1V2 intervals, V2 resumed conduction to the bundle of His (H2) but not to the atria. The mechanism of this form of gap is similar to the one proposed for the previously described gap phenomena in ventriculoatrial (V-A) conduction and involves proximal delay allowing more time for distal recovery. At shorter V1V2 intervals, V2 resumes conduction to the bundle of His because it encounters sufficient delay in some region below the His bundle. However, this delay may be insufficient to allow recovery of excitability at the A-V node and hence resumption of conduction to the atria is not an integral part of V-H gap. The relation of V-H gaps to the occurrence of reentry within the HPS (V2 phenomenon) is discussed. V-H gaps also explain the failure of some ventricular premature beats (VPBs) to show the effects of concealed conduction in the A-V node. The similarities and differences between V-A and V-H gaps during retrograde conduction are discussed.
Authors:
C P Reddy; A N Damato; M Akhtar
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  14     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  1981  
Date Detail:
Created Date:  1981-05-26     Completed Date:  1981-05-26     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-7     Citation Subset:  IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Arrhythmias, Cardiac / physiopathology*
Bundle of His / physiopathology*
Electrocardiography
Heart Conduction System / physiopathology*
Humans
Male
Middle Aged
Purkinje Fibers / physiopathology*

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


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