The ailing A-V junction

The "ailing A-V junction" includes a spectrum of arrhythmias and conduction defects owing to abnormalities in impulse formation (junctional rhythms), impulse conduction (A-V dissociation), and impulse storage (ventricular pre-excitation). A schema is presented for the identification of these dysrhythmias based upon modern electrophysiologic concepts. Hopefully, precise electrophysiologic diagnosis will yield a rational approach to therapy.