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(Circulation. 1955;11:240.)
© 1955 American Heart Association, Inc.

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The Effect of Ventricular Systole on Auricular Rhythm in Auriculoventricular Block

MAURICIO B. ROSENBAUM M.D.¹ EUGENE LEPESCHKIN M.D.¹

¹ From the Division of Experimental Medicine, University of Vermont, College of Medicine, and the Bishop DeGoesbriand Hospital, Burlington, Vermont.

In some cases of complete A-V block the curve of the duration of P-P intervals showed a sudden dip with a gradual return, during or after the T wave. This positive chronotropic (accelerating) effect of ventricular systole is probably caused by the traction exerted on the right auricle by the contracting ventricle. Other cases showed a sudden rise in the curve of P-P intervals late in diastole,followed by a gradual return. This negative chronotropic (slowing) effect is probably caused by a vagal reflex precipitated by stimulation of the arterial pressoreceptors by the pulse wave. The interplay of these two effects determines whether the P-P intervals containing QRS will be shorter than those not containing it, or whether the relation is reversed (paradox effect).

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