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(Circulation. 1971;44:696.)
© 1971 American Heart Association, Inc.

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Lown-Ganong-Levine Syndrome

A Study Using His Bundle Electrograms

WILLIAM J. MANDEL M.D.¹; RONALD DANZIG M.D.¹; H. HAYAKAWA M.D.¹

¹ From the Department of Cardiology, Cedars-Sinai Medical Center and the Department of Medicine, University of California at Los Angeles, California.

His bundle recordings were obtained in three patients with histories of recurrent supraventricular tachycardias and electrocardiograms demonstrating a short P-R interval with a normal QRS (the Lown-Ganong-Levine syndrome). The His bundle electrograms obtained during sinus rhythm demonstrated a normal A-H (atrium-to-His bundle) time in one patient and a low normal A-H time in two patients. The H-V (His bundle-to-ventricle) time was short in all three patients. Atrial pacing in two patients produced an attenuated degree of prolongation of the A-H time without a change in conduction distal to the proximal His bundle. The probable mechanisms of accelerated conduction in these three patients include: (1) partial A-V nodal bypass via (a) the posterior intenodal tract or (b) functional bypass fibers within the A-V node; and (2) accelerated conduction within the A-V conduction system distal to the A-V node.

Key Words: Accelerated conduction • Arrhythmias • Posterior internodal tract • Right bundle branch • A-V node • Paraspecific fibers

Submitted on April 16, 1971
Accepted on June 22, 1971