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European Heart Journal 1994 15(2):285-288;
Copyright © 1994 by the European Society of Cardiology.
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© 1994 The European Society of Cardiology

Double ventricular responses during extrastimulation of atrioventricular nodal reentrant tachycardia

F. SUZUKI*,, K. TANAKA*, N. ISHIHARA*, K. HIRAO*, T. KAWARA{dagger} and K. HIEJIMA{dagger}

*From the First Department of Internal Medicine, School of Medicine, Tokyo Medical and Dental University Tokyo Japan
{dagger}From the School of Allied Health Science, Tokyo Medical and Dental University Tokyo Japan

Received 21 June 1993; revised 3 September 1993; .

Correspondtnce: Furmio Suzuki, M.D. The First Department of Internal Medicine, Tokyo Medical and Dental University, Yushima 1–5- 45, Runkyo-ku, Tokyo 113, Japan

Abstract

In patients with dual atrioventricular (AV) nodal pathways, double ventricular responses to a single atrial depolarization have been shown to occur, but virtually only during a trial pacing in sinus rhythm. We report on a patient with a slow-fast form of AV nodal reentrant tachycardia who exhibited double ventricular responses following extrastimulation during AV nodal reentrant tachycardia. The phenomenon of double ventricular responses during the tachycardia was demonstrated by ex trastimulation from the proximal coronary sinus. Retrograde unidirectional block in the slow pathway, and an anterograde effective refractory period that was shorter in the fast pathway than that in the slow pathway, are suggested.

Key Words: Dual AV nodal pathways • programmed stimulation • coronary sinus • effective refractory period • conduction delay • atropine


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