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Concealed re-entry in the human heart

L Littmann, J Tenczer, T Fenyvesi

    Acta Medica Academiae Scientiarum Hungaricae
    |January 1, 1982
    PubMed
    Summary
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    Concealed re-entry, a hidden cardiac impulse pathway, was studied in 49 patients. New patterns of concealed re-entry causing Wenckebach periodicity were identified, explaining complex heart rhythm disorders.

    Area of Science:

    • Cardiology
    • Electrophysiology

    Background:

    • Concealed re-entry is an electrophysiologic event involving cardiac impulse pathways that are not directly detectable on the surface electrocardiogram.
    • Understanding concealed re-entry is crucial for diagnosing and managing various cardiac arrhythmias.

    Purpose of the Study:

    • To investigate the mechanisms and electrophysiologic manifestations of concealed re-entry in human subjects.
    • To document previously undescribed patterns of concealed re-entry and their role in cardiac impulse formation and conduction.

    Main Methods:

    • Analysis of human electrocardiograms (ECG) and intracardiac recordings from 49 patients.
    • Identification of previously described and novel patterns of concealed re-entry.
    • Evaluation of the impact of concealed re-entry on Wenckebach periodicity and supraventricular impulse conduction.

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    Main Results:

    • Previously described patterns of concealed re-entry were confirmed in 49 patients.
    • Novel manifestations of concealed re-entry were identified in seven patients, contributing to Wenckebach periodicity and "reversed" Wenckebach periods.
    • Complete circus movement of supraventricular impulses was detected in five cases using intracardiac recordings and echo beat analysis.

    Conclusions:

    • Concealed re-entry is a significant electrophysiologic event with diverse manifestations in the human heart.
    • This study identified new roles for concealed re-entry in the genesis of specific Wenckebach phenomena.
    • Intracardiac recordings and detailed analysis are essential for detecting and understanding concealed re-entry and its clinical implications.