Feb 1, 1985

Linking: a dynamic electrophysiologic phenomenon in macroreentry circuits

Circulation
M H LehmannM Akhtar

Abstract

The term "linking" has been used specifically to describe the mechanism for perpetuation of functional anterograde bundle branch block: namely, repetitive transseptal retrograde concealed penetration by impulses propagating along the contralateral bundle. We present selected examples that demonstrate tht linking-type phenomena actually have a wide spectrum of expression in human macroreentry circuits, particularly those incorporating either the bundle branches and His bundle or the normal pathway and Kent bundle. The examples presented are as follows: (1) persistent retrograde functional conduction delays in the His-Purkinje system during right ventricular pacing, (2) anterograde Kent bundle condution at rapid rates, dependent on prior block in the normal pathway, (3) persistent anterograde functional infra-His block of atrial impulses during rapid ventricular pacing in the presence of a retrogradely conducting accessory pathway, and (4) transient advancement of His activation with ventricular fusion complexes during overdrive ventricular pacing of bundle branch reentrant tachycardia. Based on these examples, we characterize linking as a generalized electrophysiologic phenomenon in which each successive impulse entering a macro...Continue Reading

Mentioned in this Paper

Biochemical Pathway
Left Ventricular Structure
Accessory Atrioventricular Bundle
Complex (molecular entity)
Bundle-Branch Block
Limb Structure
Accessory Atrioventricular Bundle (Body Structure)
Cardiac Conduction System
Electrophysiology (Science)
Bundle of His

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