Search PubMed⌕ Search

Biomedical subjects

G Konishi

Publications and source records attributed to G Konishi.

25 records · Page 2Linked to original sources

Influence of sinus impulses on the parasystolic cycle length.

Recently, it has been shown that in most clinical cases of parasystole, the parasystolic rhythm is not completely independent of the sinus rhythm. In this study, to disclose the mechanism of such "irregular" parasystole, parasystolic cycles with an intervening sinus QRS complex (XSX) were compared with their immediately adjacent pure parasystolic cycles without any intervening nonparasystolic QRS complexes (XX) in 10 cases of ventricular parasystole. In eight cases, the XSX interval was equal to or nearly equal to the adjacent pure XX interval; in one, the XSX interval was shorter than the XX interval; and in only one, the XSX interval was longer than the XX interval. In six cases in which the XSX interval was almost equal to the XX interval, calculated XSX intervals with a later intervening sinus QRS complex were obtained from the differences between the XSSX interval (ie, interectopic interval with two intervening sinus QRS complexes) and its adjacent XX interval. In five of the six cases, the calculated XSX interval was shorter than the XX interval. These observations suggest that in most cases of parasystole, early intervening sinus impulses do not change the parasystolic cycle, whereas late intervening sinus impulses shorten the parasystolic cycle. This suggests the presence of type I second-degree entrance block as the mechanism of "irregular" parasystole.

Adolescent↗

Mechanisms of atypical atrioventricular Wenckebach periodicity. A theoretical model derived from the concepts of inhomogeneous excitability and electrotonically mediated conduction.

To explain the mechanisms of atypical atrioventricular (AV) Wenckebach periodicity, a model of the AV node was theoretically derived from the concepts of "inhomogeneous excitability" and "electrotonically mediated conduction." The theoretical model of the AV node has the following characteristics: (1) increased vagal tone depresses excitability in the AV node, (2) depressed excitability in the AV node is inhomogeneous in both transverse and longitudinal directions, and (3) electrotonically mediated conduction occurs across inexcitable gaps in the AV node. Many features in atypical AV Wenckebach periodicity are explained by the use of this model. Delayed AV conduction is caused mostly by electrotonically mediated conduction across a much-depressed region in the AV node, and thereafter AV conduction is blocked at the same region, resulting in the occurrence of an AV Wenckebach period with gradual lengthening of PR intervals. Occasionally, longitudinal dissociaton and concealed reentry in the AV node occur in the part below (distal to) the above depressed region, resulting in the occurrence of an AV Wenckebach period with sudden marked lengthening of a PR interval. The sinus impulse following such suddenly delayed AV conduction is usually blocked in the AV node as the result of concealed reentry of the preceding impulse.

Arrhythmias, Cardiac↗

Type A alternating Wenckebach periodicity in the reentrant pathway of interpolated ventricular extrasystoles.

A 67-year-old man with interpolated ventricular extrasystoles is reported in whom alternate sinus QRS complexes were followed by interpolated ventricular extrasystoles with progressively lengthening coupling intervals until one of these alternate sinus complexes failed to be followed by an extrasystole. This is the first report to suggest the presence of type A alternating Wenckebach periodicity in the reentrant pathway of interpolated ventricular extrasystoles. It is suggested that 2:1 block occurred at a proximal level in the reentrant pathway, while Wenckebach block occurred at a distal level in the pathway.

Aged↗

Atrioventricular Wenckebach periodicity in athletes: influence of increased vagal tone on the occurrence of atypical periods.

In 37 athletes with atrioventricular (AV) Wenckebach periodicity, the relationship between PP and RR intervals was investigated. In most athletes, when PP intervals gradually lengthened, RR as well as PR intervals usually also gradually lengthened until a blocked P wave occurred, resulting in the occurrence of an atypical Wenckebach period with prolongation of the last RR interval (variant I). In 20 athletes, sudden marked prolongation of a PR interval occasionally occurred, which was usually followed by a blocked P wave (variant II). In five athletes, once sudden marked prolongation of a PR interval occurred, markedly long PR intervals were maintained for some time, and then a PR interval suddenly shortened without a blocked P wave (variant III). It appeared that the above findings were caused by spontaneous variations in vagal tone. It was suggested that longitudinal dissociation and concealed reentry in the AV node occurred in atypical Wenckebach periods of variants II and III, but not in the other periods.

Adolescent↗