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Linking phenomenon during atrial stimulation with accessory pathways.

A Castellanos, B Portillo, L Zaman

    The American Journal of Cardiology
    |November 1, 1986
    PubMed
    Summary
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    Linking and entrainment are terms describing electrophysiologic phenomena in macroreentry circuits. This study reveals these terms can describe the same mechanism, highlighting variations on a common theme in accessory pathway function.

    Area of Science:

    • Electrophysiology
    • Cardiology

    Background:

    • Linking is an electrophysiologic phenomenon in macroreentry circuits.
    • Functional impedance influences impulse propagation in accessory pathways.

    Purpose of the Study:

    • To analyze linking in patients with accessory pathways.
    • To clarify the relationship between linking and entrainment.

    Main Methods:

    • Electrophysiologic studies in 12 patients with accessory pathways.
    • Analysis of linking during 1:1 atrioventricular conduction via the normal pathway.
    • Atrial pacing during sinus rhythm and tachycardia.

    Main Results:

    • Linking is maintained by repetitive local refractoriness (interference) or impulse collision.

    Related Experiment Videos

  • Entrainment involves impulse collision during tachycardia.
  • Linking in sinus rhythm with slow pathways involves impulse collision but is not entrainment.

    • Conclusions:

    • Linking and entrainment can refer to the same mechanism.
    • The terms' applicability depends on pacing circumstances.
    • Diverse mechanisms in macroreentry circuits involving accessory pathways are variations of a common electrophysiologic theme.