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Retrograde dual atrioventricular nodal pathways

B Strasberg, S Swiryn, R Bauernfeind

    The American Journal of Cardiology
    |October 1, 1981
    PubMed
    Summary

    Retrograde dual atrioventricular (A-V) nodal pathways are uncommon, found in 3.5% of patients. These pathways are linked to unusual A-V nodal reentrant ventricular echoes and supraventricular tachycardia.

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    STUDIES ON THE BIOCHEMICAL, BIOPHYSICAL, AND IMMUNOGENIC PROPERTIES OF JAPANESE B TYPE ENCEPHALITIS VIRUS AND VACCINES.

    The Journal of experimental medicine·2009

    Area of Science:

    • Electrophysiology
    • Cardiology
    • Cardiac Electrophysiology

    Background:

    • Dual atrioventricular (A-V) nodal pathways can exhibit unidirectional or bidirectional conduction properties.
    • Retrograde dual A-V nodal pathways are considered uncommon in clinical practice.

    Purpose of the Study:

    • To investigate the prevalence and electrophysiological characteristics of retrograde dual A-V nodal pathways.
    • To determine the association of retrograde dual A-V nodal pathways with A-V nodal reentrant phenomena and tachycardia.

    Main Methods:

    • Retrospective analysis of electrophysiological study data from 887 patients.
    • Identification of retrograde dual A-V nodal pathways based on discontinuous conduction curves or dual ventriculoatrial (V-A) intervals.
    • Assessment for A-V nodal reentrant ventricular echoes and paroxysmal supraventricular tachycardia (PSVT).

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    Main Results:

    • Thirty-one patients (3.5%) exhibited retrograde dual A-V nodal pathways.
    • All patients with retrograde dual pathways showed A-V nodal reentrant ventricular echoes.
    • Eleven patients (35%) also had anterograde dual A-V nodal pathways (bidirectional).
    • Twenty-six percent of patients had spontaneous or inducible A-V nodal reentrant PSVT.

    Conclusions:

    • Retrograde dual A-V nodal pathways are infrequent but consistently associated with A-V nodal reentrant ventricular echoes.
    • These pathways are often accompanied by anterograde dual pathways and A-V nodal reentrant tachycardia.
    • The retrograde slow pathway serves as the critical component in the reentrant circuit.