Re entry due to manifest and concealed His bundle ectopic systoles. Report of a case

N. El-Sherif, B. Befeler, J. Aranda, Agustin Castellanos, R. Lazzara

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

Concealed (C) His bundle ectopic systoles (H') have been shown in man to give rise to first and second degree atrioventricular (A V) block and to simulate nonconducted atrial premature beats (P'). This report outlines a hitherto undescribed electrophysiologic consequence of H' in a 69 year old man with arteriosclerotic heart disease and a Wenckebach type second degree A V block in the His Purkinje system. During a His bundle study, H' were shown to conduct either to the atria and ventricles with varying relationships to P' and QRS, or to conduct only to the atria, simulating nonconducted P' or atrial fusion beats. Both types of H' could initiate a re entrant arrhythmia during retrograde conduction. Of particular interest are late coupled H' that failed to conduct to the ventricles and also failed to activate the atria because of prior capture by the sinus impulse (CH'). These CH' could also initiate re entry by conducting retrogradely to engage the subatrial re entry circuit. Evidence is presented to suggest re entry occurs by way of a retrograde concealed accessory pathway and antegrade conduction in the atrioventricular node.

Original languageEnglish (US)
Pages (from-to)902-908
Number of pages7
JournalCirculation
Volume53
Issue number5
StatePublished - 1976
Externally publishedYes

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Bundle of His
Atrioventricular Block
Accessory Atrioventricular Bundle
Atrial Premature Complexes
Atrioventricular Node
Cardiac Arrhythmias
Heart Diseases

ASJC Scopus subject areas

  • Physiology
  • Cardiology and Cardiovascular Medicine

Cite this

El-Sherif, N., Befeler, B., Aranda, J., Castellanos, A., & Lazzara, R. (1976). Re entry due to manifest and concealed His bundle ectopic systoles. Report of a case. Circulation, 53(5), 902-908.

Re entry due to manifest and concealed His bundle ectopic systoles. Report of a case. / El-Sherif, N.; Befeler, B.; Aranda, J.; Castellanos, Agustin; Lazzara, R.

In: Circulation, Vol. 53, No. 5, 1976, p. 902-908.

Research output: Contribution to journalArticle

El-Sherif, N, Befeler, B, Aranda, J, Castellanos, A & Lazzara, R 1976, 'Re entry due to manifest and concealed His bundle ectopic systoles. Report of a case', Circulation, vol. 53, no. 5, pp. 902-908.
El-Sherif N, Befeler B, Aranda J, Castellanos A, Lazzara R. Re entry due to manifest and concealed His bundle ectopic systoles. Report of a case. Circulation. 1976;53(5):902-908.
El-Sherif, N. ; Befeler, B. ; Aranda, J. ; Castellanos, Agustin ; Lazzara, R. / Re entry due to manifest and concealed His bundle ectopic systoles. Report of a case. In: Circulation. 1976 ; Vol. 53, No. 5. pp. 902-908.
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