Mar 1, 1984

Dual atrio-ventricular nodal pathways and atrial fibrillation

Pacing and Clinical Electrophysiology : PACE
P BrugadaH J Wellens


The determinants of the ventricular rate during atrial fibrillation were studied in a group of eleven patients demonstrating dual A-V nodal pathways during atrial stimulation. The shortest R-R interval and the mean ventricular cycle length during at least 1 min of pacing-induced atrial fibrillation were compared: a) to the effective and functional refractory period of the fast pathway; b) to the effective refractory period of the slow pathway determined during atrial stimulation, at two or more different basic cycle lengths of pacing; and c) to the shortest cycle length during atrial stimulation followed by 1:1 A-V conduction. A group of 8 patients not demonstrating dual A-V nodal pathway-curves during atrial stimulation was used as a control. In both groups the shortest R-R interval during atrial fibrillation was best predicted by the shortest cycle length followed by 1:1 A-V conduction during atrial stimulation. The mean ventricular cycle length during atrial fibrillation was not accurately predicted by any of the variables studied. The similar results in patients with and without dual A-V nodal pathways suggest that concealed conduction from one to another A-V nodal pathway does not play a role in determining the ventricular...Continue Reading

Mentioned in this Paper

Left Ventricular Structure
Right Atrial Structure
Atrial Fibrillation
Cardiac Conduction System
Structure of Atrioventricular Node
Electrophysiology (Science)
Cardiac Pacing, Artificial
Pulse Rate

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