VENTRICULAR PREEXCITATION DUE TO ANOMALOUS NODO-VENTRICULAR PATHWAYS - REPORT OF 3 PATIENTS

  • 1 January 1979
    • journal article
    • research article
    • Vol. 9  (2) , 111-127
Abstract
Patients (3) with paroxysmal palpitations had surface ECG evidence of type B pre-excitation with a small positive delta wave in lead V1. All patients had an abnormally short H-V interval. Programmed atrial premature stimuli at progressively shorter coupling intervals resulted in prolongation of AV [atrioventricular] conduction time and increasing preexcitation. In 2 patients early atrial premature stimuli elicited atrial echo beats or sustained tachycardia with preexcited QRS complexes. In these patients, the accessory pathway did not appear involved in the tachycardia circuit. The site of re-entry may be in the AV node, with pre-excitation occurring as the result of conduction in an anomalous nodo-ventricular pathway. In the 3rd patient, pre-excitation occurred in a restricted range of coupling intervals of an atrial premature stimulus. The electrophysiological responses of nodo-ventricular and His-ventricular pathways to atrial stimulation are compared and contrasted.