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(Circulation. 1967;36:637.)
© 1967 American Heart Association, Inc.

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Termination of Reciprocating Tachycardia by Atrial Stimulation

R. A. MASSUMI M.D.¹; A. D. KISTIN M.D.¹; A. A. TAWAKKOL M.D.¹

¹ From the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, District of Columbia, and the Department of Medicine, Beckley-Appalachian Regional Hospital, Beckley, West Virginia. The original observations were made by Dr. Kistin, but the manuscript was completed after his death.

Recurrent tachycardia in a 10-year-old child with acute rheumatic carditis was interpreted as being produced by a reciprocating (circus) mechanism involving either the normal atrioventricular pathway or the anomalous pathway of the Wolff-Parkinson-White syndrome. The tachycardia could be stopped by appropriately timed, electrically induced, atrial premature systoles, which apparently interrupted the circus movement.

Key Words: A-V conduction • Intracardiac electrode • Circus movement • Acute rheumatic carditis • WPW syndrome

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