Mechanism of tachycardia-dependent appearance of ventricular extrasystoles in concealed bigeminy.

Abstract:

:A case of concealed ventricular bigeminy is reported in which the number of sinus QRS complexes intervening between two successive noninterpolated extrasystoles was always uneven. Coupling intervals of manifest extrasystoles to the preceding sinus QRS complexes were almost fixed and much longer than sinus QT intervals. Bradycardia-dependent disappearance of manifest bigeminy and tachycardia-dependent appearance of extrasystoles occurred in this case. Apparently, 2:1 block of sinus impulses occurred in the reentrant pathway, with markedly depressed conductivity. Concealed electrotonic conduction of blocked sinus impulses in the pathway of extrasystoles may have favored the appearance of the subsequent manifest extrasystoles without concealed conduction owing to two-level block. A possible explanation for the mechanism of such concealed bigeminy is presented, which uses the concepts of longitudinal dissociation and electrotonic inhibition in the reentrant pathway with markedly depressed conductivity.

journal_name

J Electrocardiol

authors

Kinoshita S,Tanabe Y,Satoh T

doi

10.1016/s0022-0736(96)80100-2

subject

Has Abstract

pub_date

1996-10-01 00:00:00

pages

341-5

issue

4

eissn

0022-0736

issn

1532-8430

journal_volume

29

pub_type

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