We report a patient with second degree A-V block in whom several sinus impulses were conducted over the slow A-V nodal pathway, resulting in P-R intervals so prolonged to suggest a diagnosis of intermittent advanced A-V block with A-V junctional escape complexes. However, the "escape" cycles were markedly irregular, and moreover, "escape" complexes often occurred with R-R cycles shorter than those ended by conducted sinus beats. These observations suggested that no escape mechanism was present. The marked variability of P-R intervals was a manifestation of dual A-V nodal pathways: short P-R intervals expressed conduction over the fast pathway, whereas long P-R intervals corresponded to sinus impulses conducted over the slow pathway.

Advanced A-V block with apparent A-V junctional escape complexes because of dual A-V nodal pathways

LUZZA, Francesco;CARERJ, Scipione;ORETO, Giuseppe
2001-01-01

Abstract

We report a patient with second degree A-V block in whom several sinus impulses were conducted over the slow A-V nodal pathway, resulting in P-R intervals so prolonged to suggest a diagnosis of intermittent advanced A-V block with A-V junctional escape complexes. However, the "escape" cycles were markedly irregular, and moreover, "escape" complexes often occurred with R-R cycles shorter than those ended by conducted sinus beats. These observations suggested that no escape mechanism was present. The marked variability of P-R intervals was a manifestation of dual A-V nodal pathways: short P-R intervals expressed conduction over the fast pathway, whereas long P-R intervals corresponded to sinus impulses conducted over the slow pathway.
2001
File in questo prodotto:
Non ci sono file associati a questo prodotto.
Pubblicazioni consigliate

I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.

Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11570/1592534
 Attenzione

Attenzione! I dati visualizzati non sono stati sottoposti a validazione da parte dell'ateneo

Citazioni
  • ???jsp.display-item.citation.pmc??? 0
  • Scopus 6
  • ???jsp.display-item.citation.isi??? 5
social impact