Circulation, Vol 52, 563-569, Copyright © 1975 by American Heart Association
AM Tonkin, HC Miller, RH Svenson, AG Wallace and JJ Gallagher
Antegrade (AERPAP) and retrograde (RERPAP) effective refractory periods of
the accessory pathway were measured at multiple cycle lengths in 47
patients with the Wolff-Parkinson-White syndrome. In 20 patients the effect
of changing cycle length on AERPAP could be determined. In 12 patients
Aerpap decreased by 10-45 msec, in six it increased by 10-35 msec, and in
two it was unchanged. In 13 of 15 patients in whom the effect of decreasing
cycle length on RERPAP could be assessed, RERPAP decreased by 10-60 msec.
In eight patients, the shortest AERPAP correlated well (r equals 0.83) with
the shortest R-R interval of consecutive pre-excited beats in atrial
fibrillation. However, predominantly normal conduction was observed in six
of 28 patients with atrial fibrillation, probably because of concealment in
the bypass. Therefore, induction of atrial fibrillation during
electrophysiological evaluation may privide additional information. The
RERPAP at the cycle length of the arrhythmia was shorter than the cycle
length of reciprocating tachycardia in all but one of 21 patients. At the
same or comparable cycle lengths, AERPAP was usually greater than RERPAP.
ARTICLES
Refractory periods of the accessory pathway in the Wolff-Parkinson- White syndrome
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