Physiologic Basis of Premature Beats and Sustained Tachycardias

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Abstract
ONLY two mechanisms are involved in the genesis of a wide variety of disorders of cardiac rhythm ranging from isolated premature beats to self-sustained, rapid, and potentially lethal cardiac arrhythmias: impulse generation in an ectopic focus, or reentry (i.e., a "circus movement"). Both re-entry and ectopic automatic foci can be demonstrated experimentally, and both are possible in the clinical situation. Although in patients it may be exceedingly difficult to decide which of the two is responsible for a particular disturbance in cardiac rhythm, this distinction has practical consequence. The rational use of pharmacologic agents or electrical devices (or both) in . . .