Isorhythmic Dissociation--a "physiological" arrhythmia.

Abstract:

:The behavior of the sino-atrial mechanism in isorhythmic dissociation (IRD) was studied in 21 patients, nine with spontaneous IRD and 12 with artificially pacemaker-induced IRD following electrode placement for heart block. Successive P-P, R-R and P-R intervals and blood pressure (BP) fluctuations were determined and graphically interrelated at control and during IRD. Several features were observed: a. IRD was present only when the independent ventricular rate was close to the atrial; b. P rate oscillations closely followed the P-R interval-dependent BP fluctuations (mean difference 30 mmHg) during IRD. In cardiogenic shock and in severe hypertension IRD could not be achieved easily; c. While during complete dissociation or during 1:1 A-V conduction the sinus rate was remarkably constant (2-4 beats/min variations), it showed marked oscillations (differences of 6-19, mean 13, beats/min) during IRD. All the data and calculations support the theory that in most instances of IRD, the arrhythmia is sustained by the normal physiologically active baroreceptor reflex arc.

journal_name

J Electrocardiol

authors

Kaplinsky E,Aronson R,Neufeld HN

doi

10.1016/s0022-0736(77)80052-6

subject

Has Abstract

pub_date

1977-04-01 00:00:00

pages

179-88

issue

2

eissn

0022-0736

issn

1532-8430

journal_volume

10

pub_type

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