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Related Experiment Videos

Linking: a dynamic electrophysiologic phenomenon in macroreentry circuits.

M H Lehmann, S Denker, R Mahmud

    Circulation
    |February 1, 1985
    PubMed
    Summary

    Linking phenomena, previously specific to bundle branch block, are broadly observed in human macroreentry circuits. This study generalizes linking as a functional block mechanism crucial for perpetuating reentry.

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    Area of Science:

    • Electrophysiology
    • Cardiac Electrophysiology
    • Cardiology

    Background:

    • The term "linking" has been historically defined to explain functional anterograde bundle branch block via repetitive transseptal retrograde concealed penetration.
    • Macroreentry circuits in the human heart, involving structures like the His bundle, bundle branches, and Kent bundle, exhibit complex electrophysiologic behaviors.

    Observation:

    • This study presents four examples demonstrating a wider spectrum of linking-type phenomena in various human macroreentry circuits.
    • Observations include persistent conduction delays, rate-dependent conduction, infra-His block, and transient His activation advancement during specific pacing protocols.

    Findings:

    • Linking is characterized as a generalized electrophysiologic phenomenon where impulses preferentially propagate along one limb of a macroreentry circuit due to functional block in the contralateral limb.

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  • This functional block is dynamically maintained by repetitive impulse interference or collision, perpetuating local refractoriness or influencing impulse propagation.

    • Implications:

    • The generalized concept of linking provides a unified framework for understanding diverse reentry circuits in the human heart.
    • This understanding can advance the diagnosis and management of cardiac arrhythmias originating from macroreentry mechanisms.