May 1, 1991

A unified model of atrioventricular nodal conduction predicts dynamic changes in Wenckebach periodicity

Circulation Research
M TalajicS Nattel

Abstract

The atrioventricular (AV) node responds in a complex fashion to changes in activation rate. A variety of approaches have been used to explain these dynamic AV nodal responses, but none has been able to account fully for AV nodal behavior. Three specific rate-dependent properties of the AV node have been described: 1) time-dependent recovery after excitation, 2) an effect of short cycles to advance recovery ("facilitation"), and 3) a gradual slowing of conduction in response to sustained, high-frequency activation ("fatigue"). We hypothesized that a model incorporating quantitative descriptors of all three processes might be able to account for a wide variety of AV nodal behaviors. Quantitative descriptors of AV nodal recovery, facilitation, and fatigue were developed based on AV nodal conduction changes during selective pacing protocols in seven autonomically blocked dogs. These descriptors were incorporated into a set of mathematical equations that define AV nodal conduction of any beat based on activation history. The equations were then applied to predict pacing-induced Wenckebach periodicity in each dog. Experimental data were obtained after nine to 19 step decreases in atrial cycle length into the Wenckebach zone in each a...Continue Reading

  • References27
  • Citations25

Mentioned in this Paper

Heart Block
Atrioventricular Block
Structure of Atrioventricular Node
NODAL gene
Fatigue
Familial Mediterranean Fever
Facilitation
Heart Atrium
Cardiac Pacing, Artificial
Cardiac Conduction

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