SEARCH · Search PubMed

Results for “CIRCUS”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

SourceResearch connectionFrom yearThrough year

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 73 records · Page 4Linked to original sources

PubMed1987

Orthodromic pacemaker circus movement tachycardia.

We report on the case of a 33-year-old woman with sick sinus syndrome who had an orthodromic pacemaker circus movement tachycardia (PCMT), with antegrade atrioventricular (AV) conduction and a retrograde pathway by means of a DDD (AV universal) pacemaker. This PCMT was provoked and sustained by premature ventricular contraction-synchronous atrial stimulation (PVC-SAS), which is a new feature for the prevention of antidromic PCMTs. The conditions for occurrence of this tachycardia were: PVC-SAS; atrial undersensing; first degree AV block. Recommendations for prevention of this pacemaker-mediated tachycardia are given.

Adult↗

PubMed1991

Orthodromic and antidromic pacemaker circus movement tachycardia.

Pacemaker circus movement tachycardia (PCMT) during DDD pacing is usually sustained by retrograde natural and antegrade electronic atrioventricular (AV) conduction. As PCMT is often initiated by a ventricular premature beat (VPB) one method of its prevention is the programming of an atrial stimulus synchronously following a ventricular extrasystole. A patient is described with preserved antegrade, but without retrograde, i.e., VA, conduction. The optional pacemaker mode of synchronous atrial stimulation following a VPB caused an unusual PCMT sustained by retrograde electronic and antegrade natural AV conduction. This PCMT is similar to a natural reentry tachycardia, the most common variety of which (based on retrograde conduction) is termed antidromic and that which we describe is orthodromic.

Adult↗

PubMed1993

Alterations of orthodromic circus movement tachycardia by dual atrioventricular nodal pathways in a patient with Wolff-Parkinson-White syndrome.

In a patient with a left sided accessory pathway (AP) three different types of orthodromic circus movement tachycardia were observed: (1) narrow QRS complex tachycardia with a stable cycle length (CL); (2) wide QRS complex tachycardia with a functional bundle branch block ipsilateral to the AP, which, paradoxically, had a shorter CL. The decrease in CL was due to a decrease of the AH interval; and (3) narrow QRS complex tachycardia with alternating CL, due to alternations of the AH interval. These phenomena were attributed to a concomitant dual atrioventricular (AV) node, which was eventually proven after successful catheter ablation of the AP.

Aged↗

PubMed1996

Cure of incessant pacemaker circus movement tachycardia by radiofrequency catheter ablation.

INTRODUCTION: Treatment of pacemaker circus movement tachycardia (PCMT) in patients with very long VA conduction times may present a problem. METHODS AND RESULTS: PCMT occurred in a 46-year-old woman with an uncommon AV nodal reentrant tachycardia who developed 2:1 AV block after fast pathway radiofrequency catheter (RF) ablation performed at another institution. Due to the long VA conduction time, PCMT could not be prevented by reprogramming the pacemaker or by the addition of antiarrhythmic drugs. Cure of the PCMT was obtained after selective RF ablation of the slow AV nodal pathway. CONCLUSION: RF ablation of the retrograde conduction offers another alternative for treatment of PCMT.

Catheter Ablation↗

PubMed2006

Effects of right bundle branch block on the antidromic circus movement tachycardia in patients with presumed atriofascicular pathways.

BACKGROUND: The typical and most common tachycardia in patients with atriofascicular pathways is a macro reentrant tachycardia, with anterograde conduction over the decrementally conducting bypass tract and retrograde conduction over the right bundle branch-His-AV node axis resulting in a short V-right bundle branch and short V-H interval. OBJECTIVES: To report on changes in rate and QRS configuration when right bundle branch block (RBBB) develops spontaneously during antidromic tachycardia using an atriofascicular fiber. METHODS: Three of 25 patients with an antidromic circus movement tachycardia using a right-sided atriofascicular pathway showed episodes of right bundle branch block (RBBB) during ventriculo-atrial conduction. Effect of retrograde RBBB on tachycardia rate and QRS configuration was studied using intracardiac and extracardiac recordings. RESULTS: All 3 patients showed prolongation of their V-A interval when retrograde RBBB occurred during tachycardia, resulting in a longer tachycardia cycle length. The VA time increase ranged from 85 to 100 msec, with a mean 346 +/- 5 msec. Two of the 3 patients also showed a change in QRS configuration due to a more leftward shift of the frontal plane QRS axis. CONCLUSION: Rate changes in antidromic tachycardia in patients with atriofascicular fibers can be based on a shift in VA conduction from one bundle branch to the other. This may be accompanied by changes in the frontal plane QRS axis because of a change in ventricular activation sequence.

Adult↗

PubMed2000

Quasiperiodic circus movement in a loop model of cardiac tissue: multistability and low dimensional equivalence.

This paper discusses the dynamics of the circus movement around a one-dimensional continuous and uniform loop of model cardiac cells. The membrane ionic currents are represented by a modified Beeler-Reuter formulation. The description of the quasiperiodic regimes initiated in a previous paper is completed and their equivalence with those predicted by an integral-delay model is discussed. The two models differ in the number of quasiperiodic modes of reentry that can be sustained and in the type of bifurcation by which they appear. These differences are the consequences of the modulation of the repolarization phase by diffusion in the ionic model. A modified version of the integral-delay model that includes a spatial averaging in the calculation of the action potential duration is shown to suppress the discrepancies.

Action Potentials↗

PubMed1981

Spontaneous termination of circus movement tachycardia using an atrioventricular accessory pathway: incidence, site of block and mechanisms.

The incidence, mechanisms and sites of block of spontaneous termination of circus movement tachycardia (CMT) using an atrioventricular accessory pathway (AP) were analyzed in 24 consecutive patients (17 with Wolff-Parkinson-White syndrome and seven with a concealed AP) who were not receiving antiarrhythmic drugs. Spontaneous termination of tachycardia occurred in 10 patients (105 episodes). A reduced "safety margin" of tachycardia was the only factor that was significantly more common in the patients who manifested spontaneous termination (p less than 0.01). The site of spontaneous block was located in the AP in six patients (50 episodes), atrioventricular node (AVN) in six patients (37 episodes) and His-Purkinje system (HPS) in three patients (18 episodes). At least 14 mechanisms leading to block in the tachycardia circuit were identified. Labile conduction during tachycardia occurred at multiple sites (AVN, His bundle, bundle branches, and AP). Analysis of the duration of tachycardia before spontaneous termination showed a characteristic time pattern for block at each site, consistent with the autonomic and electrophysiologic changes that occur after induction of tachycardia. Spontaneous termination of CMT using an AP is a common phenomenon. Many mechanisms are involved, which are often complex and dependent on interplay of the electrophysiologic characteristics of the components of the tachycardia circuit.

Adolescent↗

PubMed1979

Circus movement in canine right ventricle.

The present study reports on the epicardial spread of excitation during premature beats and during the initial stages of ventricular fibrillation, both of which were induced by single-test stimuli during regional ischemia or local hypothermia. Simultaneous recording of the activity at 48 epicardial sites on the right ventricle of dog hearts enabled us in some instances to demonstrate a circus movement.

Animals↗

PubMed1991

Circus movement atrial flutter in the canine sterile pericarditis model. Differential effects of procainamide on the components of the reentrant pathway.

To evaluate the mechanisms of action of procainamide on the components of the reentrant pathway, drug-induced changes in activation patterns, effective refractory periods (ERPs), and stimulation thresholds were analyzed in nine dogs with sterile pericarditis and sustained atrial flutter. Activation maps were based on 127 close bipolar recordings from a special "jacket" electrode. From the control map, 22 +/- 2 sites covering the slow zone and the normal zone of the reentrant circuit were selected to measure ERPs and thresholds. The excitable gap was estimated from the longest ERP during pacing at the tachycardia cycle length. During atrial flutter, epicardial activation proceeded as a single wave around an arc of functional conduction block in the proximity of the atrioventricular (AV) ring or around a combined functional/anatomic obstacle, with the arc being contiguous with one of the venae cavae. An area of slow conduction, which accounted for 53 +/- 15% of the revolution time within 35 +/- 15% of the total length of the reentrant pathway, was bordered by the arc of block and the AV ring or a caval vein and the AV ring, respectively. Procainamide (5-10 mg/kg i.v.) prolonged the cycle length of atrial flutter from 144 +/- 17 to 190 +/- 24 msec (p less than 0.05) and then terminated the arrhythmia in all studies. The increase in cycle length was due to an increase in conduction time in the slow zone by 37 +/- 11 msec (86 +/- 17% of the total cycle length increase). During the last reentrant beat, conduction failed in the slow zone, with the arc of block joining the AV ring. At termination, procainamide had prolonged conduction time, stimulation threshold, and ERP in the normal zone by 11 +/- 18%, 40 +/- 80%, and 5 +/- 15%, respectively, compared with 51 +/- 16%, 86 +/- 93%, and 14 +/- 21%, respectively, in the slow zone (p less than 0.05 for all three parameters). The duration of the excitable gap did not change significantly. We conclude that procainamide preferentially affected the slow zone of single loop reentrant circuits. The drug terminated circus movement atrial flutter without abolishing the excitable gap, and its effect on conduction seemed the major determinant of the antiarrhythmic action.

Animals↗

PubMed1986

Circus movement tachycardia induced by a single premature stimulus on the ventricular sheet--evaluation of the leading circle hypothesis in the canine ventricular muscle.

Mechanisms of ventricular tachycardia induced by local application of a properly timed premature stimulus were studied with routine microelectrode technique and extracellular recordings on a ventricular sheet. Thinly sliced preparations obtained from subepicardial muscle of the canine ventricle were used as an approximation of a two-dimensional model. On these preparations, spontaneously sustained tachycardia easily induced by a single premature stimulus. Since delayed after-depolarizations were never evoked by frequent stimulations even in the K+-free and high-Ca++ media, these tachycardias seemed to be induced by re-entrant and circus movement mechanisms. To analyse the re-entrant mechanisms, action potentials generated by normal driving stimuli were recorded from multiple points (40 approximately 50 points) and the spreads of the depolarization and repolarization phases of the action potentials were mapped. The depolarizing wave front on the map always showed a circular or elliptical pattern. Whenever the pattern of spread of the repolarizing wave was similar to that of the depolarizing wave, sustained tachycardia was never brought about by any premature stimulus. On the other hand, when the map of the spread of the repolarizing wave was very complicated and mixed with that of the depolarizing wave, sustained tachycardia was frequently induced. From the above results, it is suggested that the nonuniform recovery of excitability plays a role in the generation of sustained tachycardia. Moreover, a portion of the unidirectional block of the premature impulse was determined by calculated using the conduction velocity of the premature impulse and the effective refractory period in each cell; then a route of re-entry for the premature impulse was simulated.(ABSTRACT TRUNCATED AT 250 WORDS)

Action Potentials↗

PubMed1950