Retrograde Conduction from Premature Ventricular Contractions, a Common Occurrence in the Human Heart

On the basis of studies of esophageal electrocardiograms the authors conclude that retrograde conduction to the atria from premature ventricular beats is common and that the theory of normal unidirectional block in the A-V node is not tenable. In most of the cases with retrograde conduction, the latter is not discernible in simultaneously recorded lead II, which explains why the phenomenon has previously been considered rare. Observations on the ventriculoatrial conduction time and the compensatory pause are presented. In two of the cases there are two orders of magnitude of ventriculoatrial conduction time, which, the authors postulate, may be due to two separate pathways of retrograde conduction.

[1]  F. N. Wilson.  The distribution of the potential differences produced by the heart beat within the body and at its surface , 1930 .

[2]  R. Langendorf,et al.  Auriculoventricular block with ventriculoauricular response , 1944 .

[3]  R. Langendorf,et al.  RECIPROCAL BEATING INITIATED BY VENTRICULAR PREMATURE SYSTOLES , 1944, British heart journal.

[4]  E. Starling,et al.  On some Points in the Innervation of the Mammalian Heart , 1892, The Journal of physiology.

[5]  R. Ashman,et al.  A case of dextrocardia with right (functional left) ventricular predominance, ventricular ectopic beats, and retrograde conduction , 1926 .

[6]  W. Brown,et al.  A study of the esophageal lead in clinical electrocardiography: Part II. An electrocardiographic study of auricular disorders in the human subject by means of the esophageal lead , 1936 .

[7]  R. Ashman,et al.  UNIDIRECTIONAL BLOCK IN HEART MUSCLE , 1929 .

[8]  &NA; Wj.  Essentials of Electrocardiography , 1941 .

[9]  W. Brown,et al.  A study of the esophageal lead in clinical electrocardiography , 1936 .

[10]  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 .

[11]  G. R. Mines.  On dynamic equilibrium in the heart , 1913, The Journal of physiology.

[12]  Thomas Lewis,et al.  The excitatory process in the dog's heart. Part II The ventricles , 1915 .

[13]  D. Scherf.  AN EXPERIMENTAL STUDY OF RECIPROCATING RHYTHM , 1941 .

[14]  F. O. Schmitt,et al.  DIRECTIONAL DIFFERENCES IN THE CONDUCTION OF THE IMPULSE THROUGH HEART MUSCLE AND THEIR POSSIBLE RELATION TO EXTRASYSTOLIC AND FIBRILLARY CONTRACTIONS , 1928 .

[15]  W. B. Saunders.  Howell's Textbook of Physiology , 1946, The Indian Medical Gazette.