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Tachycardia and Apparent Sino‐Atrial Block Due to Concealed Sinus Node Re‐entry
Author(s) -
SATAKE SHUTARO,
BIANCHI JOHN,
DREIFUS LEONARD S.,
WATANABE YOSHIO,
MICHELSON ERIC L.
Publication year - 1983
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1983.tb04350.x
Subject(s) - medicine , crista terminalis , bigeminy , cardiology , tachycardia , sinus (botany) , atrial tachycardia , anesthesia , ventricular tachycardia , catheter ablation , atrial fibrillation , botany , genus , biology
The role of the middle intercavaJ area (“internodal pathway”) in the genesis of atrial re‐entry was studied using microelectrode techniques and the extra‐stimulus method in the rabbit heart. Following surgical interruption of the anterior and posterior internodal tracts, two patterns of re‐entry were observed using the middle internodaJ pathway manifesting alternatively as tachy‐ and brody‐arrhythmias. Re‐entry which was produced by critically timed extrastimulation at the septal branch of the crista terminalis (CT) caused tachycardia reciprocating between the sinus node (SN) and intercaval area. Spontaneous re‐entrant impulses were also observed, particularly following the addition of cedilanid (0.04 mg/L). In addition, in association with critical prolongation of conduction in the sino‐septal area, premature discharge of the dominant pacemaker fibers was observed and resulted in the appearance of bradyarrhythmias. These were commonly manifest as bigeminy and trigeminy on the surface septal electrogram. Hence concealed sinus node re‐entry could manifest itself as apparent sino‐atrial block or sino‐atrial re‐entry tachycardia.