Mar 19, 2004

Concealed conduction and dual pathway physiology of the atrioventricular node

Journal of Cardiovascular Electrophysiology
Shaowen LiuShiwen Yuan


Both concealed conduction and dual pathway physiology are important electrophysiologic characteristics of the AV node. The interaction of AV nodal concealment and duality, however, is not clearly understood. The properties of AV conduction curves in the presence and absence of a conditioning blocked impulse were prospectively studied during premature atrial stimulation in 20 patients with AV nodal reentrant tachycardia before and after slow pathway ablation and in 14 control patients. AV nodal duality in the control conduction curve in the absence of a conditioning impulse was observed in 19 (95%) of 20 patients with AV nodal reentrant tachycardia. However, AV nodal duality in the modulated conduction curve in the presence of a blocked impulse was only identified in 2 (10%) of 20 patients (2/20 vs 19/20, P < 0.0001). The modulated curve was characterized by a significantly longer AV nodal effective and functional refractory periods compared to the control curve (P < 0.0001) in both patients with and without AV nodal reentry and in AV nodal reentry patients after successful slow pathway ablation. The maximum AH interval (AH(max)) of the modulated curve was significantly shorter than the control curve in both patients with (217 +...Continue Reading

Mentioned in this Paper

Biochemical Pathway
Refractory Period, Electrophysiological
Cardiac Conduction System
Structure of Atrioventricular Node
NODAL gene
Entire Atrioventricular Node
Heart Atrium
Catheter Ablation, Transvenous
Cardiac Conduction
Atrial Premature Complexes

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