Dual atrioventricular nodal pathways: a common electrophysiologic response in children

Electrophysiologic investigation was performed on 61 children and young adults during evaluation of either cardiac dysrhythmia or pre- or postoperative congenital heart disease. The results of these studies were reviewed retrospectively to determine if longitudinal dissociation of the atrioventricular node (AVN) was present. Dual AVN pathways were detected by the atrial extrastimulus technique, using His bundle electrograms. A discontinuous H1H2 response curve indicated the presence of dual AVN pathways. There was a higher incidence of dual AVN pathways in patients with clinically evident paroxysmal supraventricular tachycardia (PSVT) than in those without PSVT. Dual AVN pathways were equally prevalent in children with corrected and uncorrected congenital cardiac defects.