Document Detail

Ventricular parasystolic couplets originating in the pathway between the ventricle and the parasystolic pacemaker: mechanism of "irregular" parasystole.
MedLine Citation:
PMID:  11455516     Owner:  NLM     Status:  MEDLINE    
This article explains the mechanism of "irregular" parasystole. Two theories have been suggested: "electrotonic modulation" and "type I second degree entrance block." This study attempts to clarify the mechanism of irregular parasystole in cases of true ventricular parasystole associated with ventricular parasystolic couplets. Cases associated with ventricular parasystolic couplets were selected from 37 clinical cases of true ventricular parasystole in which one or more pure parasystolic cycles with no intervening nonectopic QRS complexes were found. Of the 37 cases of true ventricular parasystole, ventricular parasystolic couplets were found in 4 cases. In none of the other 33 cases, ventricular parasystolic couplets were found. In all the cases coexisting with ventricular parasystolic couplets, the latter ectopic QRS complex of the couplet failed to reset the parasystolic rhythm. The above findings suggest that the latter ectopic QRS complex of the parasystolic couplet originated not in the parasystolic pacemaker but in the pathway between the ventricle and the parasystolic pacemaker. It seems that when a sinus impulse fell late in the parasystolic cycle, it passed through the site of second degree entrance block and that the parasystolic couplets originated from the reentrant pathway between the ventricle and the pacemaker. This strengthens our previous suggestion that the mechanism of irregular parasystole is governed by "type I second degree entrance block" and not by "electrotonic modulation."
S Kinoshita; T Katoh; T Mitsuoka; T Hanai; Y Tsujimura; Y Sasaki
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Journal of electrocardiology     Volume:  34     ISSN:  0022-0736     ISO Abbreviation:  J Electrocardiol     Publication Date:  2001 Jul 
Date Detail:
Created Date:  2001-07-16     Completed Date:  2001-09-13     Revised Date:  2009-11-11    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  251-60     Citation Subset:  IM    
Hokkaido Women's University, Ebetsu; Katoh Cardiovascular Clinic, Ohtsu, Japan.
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MeSH Terms
Heart Conduction System / physiopathology*
Heart Ventricles
Middle Aged
Parasystole / diagnosis*,  physiopathology*

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