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Related Experiment Videos

[Phase 3 and phase 4 block in the accessory pathway].

A Fujiki1, S Yoshida, M Tani

  • 1Second Department of Internal Medicine, Toyama Medical and Pharmaceutical University.

Journal of Cardiology
|January 1, 1990
PubMed
Summary

This study investigated phase 4 block in accessory pathways of patients with Wolff-Parkinson-White syndrome. Findings suggest phase 4 depolarization and conduction block sites correlate with specific pathway insertions, impacting tachycardia.

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Area of Science:

  • Electrophysiology
  • Cardiac Electrophysiology
  • Cardiology

Context:

  • Pacemaker activity can depress cardiac conduction during late diastole (phase 4 block).
  • Understanding the relationship between phase 4 depolarization and conduction disturbances is crucial for managing arrhythmias.
  • Intermittent Wolff-Parkinson-White syndrome presents unique challenges due to accessory pathway conduction abnormalities.

Purpose:

  • To elucidate the correlation between the site of phase 4 depolarization and conduction disturbances in accessory pathways.
  • To investigate the mechanisms of antegrade and retrograde conduction blocks in patients with intermittent Wolff-Parkinson-White syndrome.

Summary:

  • Seven patients with intermittent Wolff-Parkinson-White syndrome were studied, exhibiting tachycardia (phase 3) and bradycardia (phase 4) dependent on accessory pathway block.

Related Experiment Videos

  • Antegrade accessory pathway conduction was absent at sinus rate but present within a defined "window" during premature atrial stimulation.
  • Retrograde accessory pathway conduction varied, with some patients showing preserved conduction, others phase 3 and 4 blocks, and some complete block at the atrial insertion.

    • Impact:

    • Results suggest antegrade phase 4 block involves accessory pathway depolarization and ventricular insertion block.
    • Retrograde phase 4 block may stem from conduction disturbances at the atrial insertion of the accessory pathway.
    • Complete retrograde block can occur at the atrial accessory pathway insertion, influencing reentrant tachycardia mechanisms.