Electrophysiological demonstration of concealed conduction in the human atrium

R. J. Sung, Robert J Myerburg, Agustin Castellanos

Research output: Contribution to journalArticle

7 Citations (Scopus)

Abstract

In the course of electrophysiological evaluation of six patients with sick sinus syndrome, two patients with chronic conduction system disease and four patients with paroxysmal supraventricular tachycardia or atrial flutter-fibrillation, the phenomenon of concealed conduction within the atrium (At) was repeatedly observed. One pair of intracardiac electrodes was used to deliver electrical stimulus (St) to the high right At and two additional pairs of electrodes were utilized to record high right and low septal right atrial electrograms. The interelectrode distances were 10 mm apart. In all 12 patients, high right atrial capture could be accomplished at a pacing rate of ≥200 beats/min. Concealed intra-atrial conduction was evident when the intra-atrial conduction time of the propagated St during 2:1 St-At block was more than 40 msec longer than that during 1:1 St-At conduction at half the St frequency. This indicated that the nonpropagated St during 2:1 St-At block partially penetrated the At and in turn, delayed conduction of the subsequently propagated St. Further observations revealed that a gradual increase in the St frequency resulted in a progressive prolongation of the intra-atrial conduction time and a shifting of 2:1 to 3:1 St-At block (alternating Wenckebach periodicity in the At) in five patients. These findings clearly demonstrate the occurrence of concealed conduction in the human At.

Original languageEnglish
Pages (from-to)940-946
Number of pages7
JournalCirculation
Volume58
Issue number5
StatePublished - Dec 1 1978

Fingerprint

Electrodes
Cardiac Electrophysiologic Techniques
Sick Sinus Syndrome
Paroxysmal Tachycardia
Atrial Flutter
Supraventricular Tachycardia
Patient Rights
Periodicity
Heart Atria
Atrial Fibrillation

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

Electrophysiological demonstration of concealed conduction in the human atrium. / Sung, R. J.; Myerburg, Robert J; Castellanos, Agustin.

In: Circulation, Vol. 58, No. 5, 01.12.1978, p. 940-946.

Research output: Contribution to journalArticle

Sung, R. J. ; Myerburg, Robert J ; Castellanos, Agustin. / Electrophysiological demonstration of concealed conduction in the human atrium. In: Circulation. 1978 ; Vol. 58, No. 5. pp. 940-946.
@article{a710be895bdc4cb5a97a2453923d0095,
title = "Electrophysiological demonstration of concealed conduction in the human atrium",
abstract = "In the course of electrophysiological evaluation of six patients with sick sinus syndrome, two patients with chronic conduction system disease and four patients with paroxysmal supraventricular tachycardia or atrial flutter-fibrillation, the phenomenon of concealed conduction within the atrium (At) was repeatedly observed. One pair of intracardiac electrodes was used to deliver electrical stimulus (St) to the high right At and two additional pairs of electrodes were utilized to record high right and low septal right atrial electrograms. The interelectrode distances were 10 mm apart. In all 12 patients, high right atrial capture could be accomplished at a pacing rate of ≥200 beats/min. Concealed intra-atrial conduction was evident when the intra-atrial conduction time of the propagated St during 2:1 St-At block was more than 40 msec longer than that during 1:1 St-At conduction at half the St frequency. This indicated that the nonpropagated St during 2:1 St-At block partially penetrated the At and in turn, delayed conduction of the subsequently propagated St. Further observations revealed that a gradual increase in the St frequency resulted in a progressive prolongation of the intra-atrial conduction time and a shifting of 2:1 to 3:1 St-At block (alternating Wenckebach periodicity in the At) in five patients. These findings clearly demonstrate the occurrence of concealed conduction in the human At.",
author = "Sung, {R. J.} and Myerburg, {Robert J} and Agustin Castellanos",
year = "1978",
month = "12",
day = "1",
language = "English",
volume = "58",
pages = "940--946",
journal = "Circulation",
issn = "0009-7322",
publisher = "Lippincott Williams and Wilkins",
number = "5",

}

TY - JOUR

T1 - Electrophysiological demonstration of concealed conduction in the human atrium

AU - Sung, R. J.

AU - Myerburg, Robert J

AU - Castellanos, Agustin

PY - 1978/12/1

Y1 - 1978/12/1

N2 - In the course of electrophysiological evaluation of six patients with sick sinus syndrome, two patients with chronic conduction system disease and four patients with paroxysmal supraventricular tachycardia or atrial flutter-fibrillation, the phenomenon of concealed conduction within the atrium (At) was repeatedly observed. One pair of intracardiac electrodes was used to deliver electrical stimulus (St) to the high right At and two additional pairs of electrodes were utilized to record high right and low septal right atrial electrograms. The interelectrode distances were 10 mm apart. In all 12 patients, high right atrial capture could be accomplished at a pacing rate of ≥200 beats/min. Concealed intra-atrial conduction was evident when the intra-atrial conduction time of the propagated St during 2:1 St-At block was more than 40 msec longer than that during 1:1 St-At conduction at half the St frequency. This indicated that the nonpropagated St during 2:1 St-At block partially penetrated the At and in turn, delayed conduction of the subsequently propagated St. Further observations revealed that a gradual increase in the St frequency resulted in a progressive prolongation of the intra-atrial conduction time and a shifting of 2:1 to 3:1 St-At block (alternating Wenckebach periodicity in the At) in five patients. These findings clearly demonstrate the occurrence of concealed conduction in the human At.

AB - In the course of electrophysiological evaluation of six patients with sick sinus syndrome, two patients with chronic conduction system disease and four patients with paroxysmal supraventricular tachycardia or atrial flutter-fibrillation, the phenomenon of concealed conduction within the atrium (At) was repeatedly observed. One pair of intracardiac electrodes was used to deliver electrical stimulus (St) to the high right At and two additional pairs of electrodes were utilized to record high right and low septal right atrial electrograms. The interelectrode distances were 10 mm apart. In all 12 patients, high right atrial capture could be accomplished at a pacing rate of ≥200 beats/min. Concealed intra-atrial conduction was evident when the intra-atrial conduction time of the propagated St during 2:1 St-At block was more than 40 msec longer than that during 1:1 St-At conduction at half the St frequency. This indicated that the nonpropagated St during 2:1 St-At block partially penetrated the At and in turn, delayed conduction of the subsequently propagated St. Further observations revealed that a gradual increase in the St frequency resulted in a progressive prolongation of the intra-atrial conduction time and a shifting of 2:1 to 3:1 St-At block (alternating Wenckebach periodicity in the At) in five patients. These findings clearly demonstrate the occurrence of concealed conduction in the human At.

UR - http://www.scopus.com/inward/record.url?scp=0018174522&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0018174522&partnerID=8YFLogxK

M3 - Article

C2 - 699263

AN - SCOPUS:0018174522

VL - 58

SP - 940

EP - 946

JO - Circulation

JF - Circulation

SN - 0009-7322

IS - 5

ER -