2:1 atrioventricular block during atrioventricular node reentrant tachycardia
KC Man,
K Brinkman,
F Bogun,
B Knight,
M Bahu,
R Weiss,
R Goyal,
M Harvey,
EG Daoud,
SA Strickberger,
and
F Morady
Department of Internal Medicine, University of Michigan, Ann Arbor 48109-0022, USA.
OBJECTIVES: The purpose of this study was to determine the incidence and to clarify the mechanism of 2:1 atrioventricular (AV) block during AV node reentrant tachycardia induced in the electrophysiology laboratory. BACKGROUND: In patients with 2:1 AV block during AV node reentrant tachycardia, the absence of a His bundle potential in the blocked beats has been considered evidence of intranodal, lower common pathway block. METHODS: In consecutive patients with AV node reentrant tachycardia, the incidence of 2:1 AV block and the response to atropine and a single ventricular extrastimulus was observed. RESULTS: Persistent 2:1 AV block occurred in 13 of 139 patients with AV node reentrant tachycardia. A His bundle deflection was present in the blocked beats in eight patients and absent in five. Patients with 2:1 AV block had a shorter tachycardia cycle length than did patients without such block (mean +/- SD 312 +/- 32 vs. 353 +/- 55 ms, p < 0.01). Atropine did not alter the 2:1 block in any patient. In every patient, a single ventricular extrastimulus introduced during the tachycardia converted the 2:1 block to 1:1 conduction. CONCLUSIONS: The incidence of induced 2:1 AV block during AV node reentrant tachycardia is approximately 10%. The lack of a response to atropine and the consistent conversion of 2:1 block to 1:1 conduction by a ventricular extrastimulus indicate that, regardless of the presence or absence of a His bundle potential in blocked beats, 2:1 block during AV node reentrant tachycardia is due to functional infranodal block.
This article has been cited by other articles:
|
|
|
|
 
F. C. Chen and S. J. Asirvatham
Tachycardia and the AV Nodal Region: Guilt by Association?
Circ Arrhythm Electrophysiol,
February 1, 2010;
3(1):
2 - 6.
[Full Text]
[PDF]
|
|
|
|
|
|
|
T. Yamada, J. F. Huizar, H. T. McElderry, and G. N. Kay
Atrial tachycardia with slow pathway conduction mimicking typical atrioventricular nodal reentrant tachycardia
Europace,
May 1, 2007;
9(5):
299 - 301.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. Kazemi, M. Haghjoo, A. Arya, and M. A. Sadr-Ameli
Spontaneous high degree atrioventricular block during AV nodal re-entrant tachycardia
Europace,
June 1, 2006;
8(6):
421 - 422.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. P. Knight, M. Ebinger, H. Oral, M. H. Kim, C. Sticherling, F. Pelosi, G. F. Michaud, S. A. Strickberger, and F. Morady
Diagnostic value of tachycardia features and pacing maneuvers during paroxysmal supraventricular tachycardia
J. Am. Coll. Cardiol.,
August 1, 2000;
36(2):
574 - 582.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
B. P. Knight, A. Zivin, J. Souza, M. Flemming, F. Pelosi, R. Goyal, K. C. Man, S. A. Strickberger, and F. Morady
A technique for the rapid diagnosis of atrial tachycardia in the electrophysiology laboratory
J. Am. Coll. Cardiol.,
March 1, 1999;
33(3):
775 - 781.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
