Document Detail


Parasystole due to re-entry as the possible mechanism of ventricular parasystole with second-degree entrance block.
MedLine Citation:
PMID:  20179603     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: In 1974, Kinoshita reported a case of 'irregular parasystole' due to type I second-degree entrance block. Since then, many cases of such 'irregular' parasystole have been reported by us. To explain the mechanism of 'irregular' parasystole, two theories have been suggested, namely, 'electrotonic modulation' by Jalife and Moe, and 'type I second-degree entrance block' by us. On the contrary, in 1960, Kinoshita et al. reported a case of concealed bigeminy for the first time. The electrocardiographic findings in concealed bigeminy have suggested that there are dual re-entrant pathways with markedly long effective refractory periods in the re-entrant pathway. We have suggested that parasystole may be caused by re-entry in such re-entrant pathways. In this article, attempts are made to explain the mechanism of all the electrocardiographic findings in our cases of parasystole by 'parasystole due to re-entry'. METHODS: Using 24 studies on parasystole and 21 studies on concealed extrasystoles that we have reported over 50 years, as well as three exemplary cases in this article, attempts are made to explain all electrocardiographic findings in parasystole by 'parasystole due to re-entry'. CONCLUSIONS: The electrocardiographic findings in our previous clinical cases of parasystole and concealed extrasystoles, as well as exemplary cases and diagrams in the present article, strongly suggest 'parasystole due to re-entry' as the mechanism of ventricular parasystole with second-degree entrance block.
Authors:
Shinji Kinoshita; Takakazu Katoh; Hiroshi Yoshida
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of cardiovascular medicine (Hagerstown, Md.)     Volume:  11     ISSN:  1558-2035     ISO Abbreviation:  J Cardiovasc Med (Hagerstown)     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-03-30     Completed Date:  2010-06-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101259752     Medline TA:  J Cardiovasc Med (Hagerstown)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  327-35     Citation Subset:  IM    
Affiliation:
Hokkaido University, Sapporo, Japan. kinoshita-s@mri.biglobe.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Heart Block / complications*,  physiopathology
Heart Conduction System / physiopathology
Heart Ventricles / physiopathology
Humans
Parasystole / etiology*,  physiopathology
Comments/Corrections
Comment In:
J Cardiovasc Med (Hagerstown). 2010 May;11(5):336   [PMID:  20351496 ]

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