Dec 1, 1987

Prediction of complex atrioventricular conduction rhythms in humans with use of the atrioventricular nodal recovery curve

Circulation
Alvin ShrierLeon Glass

Abstract

Theoretical considerations indicate that complex patterns of atrioventricular conduction produced by rapid atrial stimulation can be predicted from changes in atrioventricular conduction produced by premature stimulation of the atrium. The purpose of this study was to evaluate the validity of this theoretical approach in seven patients undergoing electrophysiologic investigation. The atrioventricular nodal recovery curve was determined at two different basic cycle lengths. Subsequently, periodic atrial stimulation was delivered for 30 sec periods over a range of frequencies giving 11, Wenckebach, reverse Wenckebach, and 21 rhythms. The recovery curve data was then used to compute the response to periodic stimulation by an iterative technique. The conduction patterns actually seen during periodic atrial stimulation showed close agreement with the computed patterns. This work thus provides a unified explanation for the appearance of Wenckebach, reverse Wenckebach, alternating Wenckebach, and high grade block rhythms.

Mentioned in this Paper

Heart Block
Cardiac Catheterization Procedures
Right Atrial Structure
Cardiac Conduction System
Structure of Atrioventricular Node
Electrophysiology (Science)
NODAL gene
Heart Atrium
Cardiac Pacing, Artificial
Cardiac Conduction

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