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- Title
Doubling of the Ventricular Rate by Interpolated Junctional Extrasystoles Resembling Supraventricular Tachycardia.
- Authors
MASSUMI, RASHID; SHEHATA, MICHAEL
- Abstract
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. (PACE 2010; 945–949)
- Subjects
HEART physiology; HEART beat; CORONARY disease; ELECTROCARDIOGRAPHY; EXTRASYSTOLE; CARDIAC patients; HEART atrium; HYPERTENSION; SICK sinus syndrome; TACHYCARDIA; ETIOLOGY of diseases; EVALUATION; PATHOLOGICAL physiology
- Publication
Pacing & Clinical Electrophysiology, 2010, Vol 33, Issue 8, p945
- ISSN
0147-8389
- Publication type
Case Study
- DOI
10.1111/j.1540-8159.2010.02763.x