An Appraisal of "Supernormal" A‐V Conduction

Certain temporal patterns of A-V and V-A transmission in experimental preparations resemble phenomena attributed to "supernormal" conduction in the clinic. Detailed study of the properties of the A-V transmission system in such experiments reveals alternative explanations in which supernormality is clearly eliminated. By application of similar principles, supernormality can be eliminated as a factor in most if not all of the published examples. Three major categories can be discerned: (1) occult 2:1 A-V block, in which an idioventricular beat "retracts" an otherwise refractory barrier within the A-V node; (2) alternation between dissociated intranodal transmission pathways; and (3) "ventriculophasic" (vagal) depression of nodal conductivity.

[1]  D. Singer,et al.  Interrelationships Between Automaticity and Conduction in Purkinje Fibers , 1967, Circulation research.

[2]  G. Moe,et al.  Demonstration of a Dual A‐V Nodal Conduction System in the Isolated Rabbit Heart , 1966, Circulation research.

[3]  E. Moore.  Microelectrode Studies on Concealment of Multiple Premature Atrial Responses , 1966, Circulation research.

[4]  G. Moe,et al.  Aberrant A‐V Impulse Propagation in the Dog Heart: A Study of Functional Bundle Branch Block , 1965, Circulation research.

[5]  J. .. Abildskov,et al.  A Complex Manifestation of Concealed A‐V Conduction in the Dog Heart , 1964, Circulation research.

[6]  J. .. Abildskov,et al.  AN EXPERIMENTAL STUDY OF CONCEALED CONDUCTION. , 1964, American heart journal.

[7]  H. Burchell.  Analogy of Electronic Pacemaker and Ventricular Parasystole with Observations on Refractory Period, Supernormal Phase, and Synchronization , 1963, Circulation.

[8]  C. Fisch,et al.  Supernormal phase of atrioventricular (A-V) conduction due to potassium. A-V alternans with first-degree A-V block. , 1961, American heart journal.

[9]  S. Jonas.  Supernormal phase of A-V conduction: report of two cases. , 1959, American heart journal.

[10]  R. Langendorf.  Alternation of A-V conduction time. , 1958, American heart journal.

[11]  S. Weidmann,et al.  Effects of calcium ions and local anaesthetics on electrical properties of Purkinje fibres , 1955, The Journal of physiology.

[12]  E. Lepeschkin,et al.  The Effect of Ventricular Systole on Auricular Rhythm in Auriculoventricular Block , 1955, Circulation.

[13]  W. Dressler,et al.  Dissociation with interference in the presence of 2:1 atrioventricular block. , 1952, American heart journal.

[14]  I. R. Roth,et al.  The mechanism of irregular sinus rhythm in auriculoventricular heart block. , 1948, American heart journal.

[15]  R. Langendorf,et al.  The supernormal phase of recovery of conduction in the human heart. , 1946, Proceedings [of the] annual meeting. Central Society for Clinical Research.

[16]  H. Burchell.  Observations on additional instances of a supernormal phase in the human heart , 1942 .

[17]  F. F. Rosenbaum,et al.  Variations in A-V and V-A conduction dependent upon the time relations of auricular and ventricular systole: The supernormal phase , 1939 .

[18]  C. Wolferth.  The so-called supernormal recovery phase of conduction in heart muscle , 1928 .

[19]  R. Ashman,et al.  A supernormal phase in conduction and a recovery curve for the human junctional tissues , 1926 .

[20]  G. Moe,et al.  An Official Journal of the American Heart Association Some Characteristics of Transmembrane Potentials of AV Nodal Cells during Propagation of Premature Beats , 2022 .