Atrioventricular nodal parasystole∗

Chung, Koo-Young; Walsh, Thomas J.; Massie, Edward

doi:10.1016/0002-9149(64)90175-4

Cited by 11 publications

(3 citation statements)

References 18 publications

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“…But the parasystolic center may work arrhythmically owing to a change of nerve tonus, conduction delay or fluctuation in the degree of exit block. Other authors , Scherf et al 1960and Chung et al 1964) observed marked variation of the shortest parasystolic cycles. Protection of an ectopic center may not be permanent, and its temporary suppression leads to what has been termed ,,intermittent" parasystole (Gerhard and Renschler 1967 and Chung et al 1964).…”

Section: Intermittence and The Autonomic Nervous Systemmentioning

confidence: 86%

“…Protection of an ectopic center may not be permanent, and its temporary suppression leads to what has been termed ,,intermittent" parasystole (Gerhard and Renschler 1967 and Chung et al 1964). But the parasystolic center may work arrhythmically owing to a change of nerve tonus, conduction delay or fluctuation in the degree of exit block.…”

Section: Intermittence and The Autonomic Nervous Systemmentioning

confidence: 99%

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Supraventicular parasystole

Nakamoto¹

1973

Basic Res Cardiol

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Out of 27 cases of ventricular and supraventricular parasystole observed in [1969][1970] 7 cases of atrial, 4 cases of A-V junctional and 2 cases of sinus parasystole were presented.1. In 13 cases of supraventricular parasystole, exit block was found in 92 per cent, atrial fusion in 38 per cent, intermittent hi-and trigeminiy in 92 per cent, aberrant ventricular conduction in 82 per cent, resetting of the basic rhythm by the parasystolic beat in 75 per cent, and A-V prolongation of the parasystolic beat in all cases of atrial parasystole and in 1 of 3 cases of A-V junctional parasystole.2. Two cases of sinus parasystole revealed that atrial or A-V junctionaI escape rhythm can be induced not only by sinus slowing but also by sinus acceleration with intermittent, repetitive, second degree S-A block.3. The following ECC findings strongly indicate the presence of supraventricular parasystole: a) intermittent or alternating occurrence of bi-and trigeminy, b) concurrent occurrence of a premature beat with a compensatory pause and that with interpolation and a short returning cycle, c) various forms of atrial fusion waves, and d) various degrees of ventricular aberration with variable coupling intervals.4. In atrial and A-V junctional parasystoles, the retrograde A-S conduction pathway is less refractory than the antegrade A-V conduction pathway, which causes 2 kinds of exit block. One is a hi-directional exit block in which there occurs neither antegrade nor retrograde conduction. The other is a uni-directional exit block in which there occurs retrograde conduction which is not accompanied by antegrade conduction.Atrial parasystole was first reported by Kaulmann and Rotberger (1921), A-V junctional parasystole by Scherf and associates (1960) and ~inus parasystole by Schamroth (1967). Scherf and Schott (1953) defined pararrhythmia as an arrhythmia in which two centers concurrently and independently produce impulse, s which yield contractions of the whole or parts of the heart, without disturbances of conduction of the normal impulse being responsible for the arrhythmia. According to Schamroth (1964) who differentiated parasystole from dissociation with interference, parasystole is a dual rhythm whereby a) pacemakers concurrently and independently contribute to the rhythm of the heart, and b) the ectopic pacemaker is protected from the, impulses of the other pacemaker, such protection being situated within, or in the immediate vicinity of, the ectopic "I The outlines of this paper were read before the 36th annual meeting of the Japanese Circulation Society, Kanazawa, April I0, 1972. K. Nakamoto, Supraventicular parasystole 453 pacemaker and protecting it during all phases of the ectopic cycle, i. e., during both its refractory phase and its apparent non-refractory phase.Electrocardiographic criteria of parasystole given by Chung (1968) include the following, a) varying coupling interval, b) constant shortest interectopic interval and c) frequent appearance of fusion beats. Also yon Knorre and Hafemeister (1969) post...

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Section: Intermittence and The Autonomic Nervous Systemmentioning

confidence: 86%

Section: Intermittence and The Autonomic Nervous Systemmentioning

confidence: 99%

Supraventicular parasystole

Nakamoto¹

1973

Basic Res Cardiol

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“…Chungl1 (1968) reported 21 cases of AVJPS, ten of which had been previously cited 11. No specific details are mentioned, although SO percent had significant aberrant conduction and 20 percent had more than 0.13 sec variation in the shortest interecto~ic interval.…”

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confidence: 99%

His Bundle Parasystole: A Form of A-V Junctional Parasystole

Lightfoot

1974

Chest

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Parasystolic property of the ectopic focus

Nakamoto

1975

Basic Res Cardiol

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Among 4476 ECGs recorded from May 1972 to April 1973, 206 ECGs showed various arrhythmias. All ECGs showing any kind of arrhythmia were recorded for 2 to 4 minutes in order to obtain more than 3 premature beats in one tracing. Of 141 ECGs with premature beats from 126 cases, more than 2 interectopic parasystolic intervals could be measured in 122 cases (96.8% of those with premature beats and 2.7% of all the patients examined). More than 3 coupling intervals could be measured in 117 patients with premature beats. In only 13 of these 117 cases (11.1%), the coupling interval varied less than 0.04 second and less than 0.02 second in 2 cases (1.7%). 1) The parasystolic cycle length ranged between less than 0.20 and more than 2.51 seconds with 82.8% of them being in a range between 0.21 and 1.00 second. 2) The fluctuation rate of the parasystolic cycle length ranged between less than 1.0 and more than 15.1. It was between less than 1.0 and 5.0 in 56,6%, between 5.1 and 10.0 in 30.0% and between 10.1 and more than 15.1 in 13.1%. 3) Fusion beats were observed in 44 of 122 cases in which the interectopic parasystolic cycle length could be determined (36.1%). Of these 44 fusions 14 were found in atrial, 14 in A-V junctional and 16 in ventricular parasystole. 4) Theories of re-entry and ectopic enhancement were discussed.

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Atrioventricular nodal parasystole∗

Cited by 11 publications

References 18 publications

Supraventicular parasystole

Supraventicular parasystole

His Bundle Parasystole: A Form of A-V Junctional Parasystole

Parasystolic property of the ectopic focus

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