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Ventriculo-atrial conduction associated with ventricular premature beats. Study with his bundle electrography.

In a group of eight patients with ventricular premature beats, ventriculoatrial conduction, with retrograde activation of the His bundle and the atria could be demonstrated by His bundle electrograms in four subjects. All had early ventricular premature beats with coupling indices between 210 and 350 msec. In the other four cases, concealed retrograde conduction could be demonstrated in the A-V nodal area. The ventricular ectopic beats were late, and depending upon the refractory period of the A-V node these extrasystoles were interpolated or followed by compensatory pauses.

Adult↗

[Spontaneous blocks by intra-atrial conduction disorders of reciprocating atrioventricular rates using a Kent's bundle].

Paroxysmal tachycardia in Type A Wolff-Parkinson-White syndrome was due to a reciprocating rhythm involving a left lateral Kent Bundle in the retrograde direction. Spontaneous interruption of the reentry resulted not from block in the normal or accessory atrioventricular pathways but from an intraatrial conduction defect: delay in conduction between the left and right atria on intraatrial reentry terminated the tachycardia.

Adult↗

Ventricular extrasystoles masquerading as aberrantly conducted atrial extrasystoles because of postectopic T wave change.

This presentation reflects a case where broad and bizarre premature QRS complexes are preceded by sinus beats whose T wave is "abnormal," and seems to contain a premature P wave. A diagnosis of atrial extrasystoles with aberrancy thus could be entertained. The extrasystoles, however, are ventricular in origin. The pattern is explained on the basis of postectopic T wave change, that is, the change in configuration of the T wave that occurs in the sinus beat after an extrasystole.

Cardiac Complexes, Premature↗