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Intermittent Ventricular Bigeminy as an Expression of Two‐Level Wenckebach Periodicity in the Reentrant Pathway of Extrasystoles
Author(s) -
KINOSHITA SHINJI,
KONISHI GO,
KINOSHITA YORKO
Publication year - 1990
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.1540-8159.1990.tb02010.x
Subject(s) - bigeminy , medicine , cardiology , qrs complex , electrocardiography , ventricular tachycardia
A patient with intermittent ventricular bigeminy is reported in whom the presence of two‐level Wenckebach periodicity in the reentrant pathway of extrasystoles is suggested. When sinus arrest was caused by vagal stimulation, no ectopic QRS complex occurred. This indicated that ventricular bigeminy was not parasystolic bigeminy but ordinary extrasystolic bigeminy. Observations of the electrocardiogram suggested that Wenckebach block occurred at two different levels in the reentrant pathway of ventricular extrasystoles. When extrasystoles were noninterpolated, Wenckebach block occurred at the distal level of the pathway and caused termination of ventricular bigeminy. On the other hand, when extrasystoles were interpolated, Wenckebach block occurred at the proximal level of the pathway. This is the first report to suggest the presence of two‐level Wenckebach periodicity in a reentrant pathway of extrasystoles.