This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via Google Scholar Google Scholar Articles by ZEFT, H. J. Articles by MCGOWAN, R. L. Search for Related Content PubMed Articles by ZEFT, H. J. Articles by MCGOWAN, R. L.

(Circulation. 1969;40:919.)
© 1969 American Heart Association, Inc.

---

Termination of Paroxysmal Junctional Tachycardia by Right Ventricular Stimulation

HOWARD J. ZEFT M.D.¹ RONALD L. MCGOWAN USAF, MC¹

¹ From the Division of Cardiology, Department of Medicine, Duke University Medical Center, and the Durham Veterans Administration Hospital, Durham, North Carolina.

This report documents the use of right ventricular stimulation in the termination of a rapid junctional tachycardia. The tachycardia developed in the background setting of heart block and bradycardia. Right ventricular stimulation was effective at 94/min, a rate considerably slower than that of the tachycardia. Analysis of pacemaker stimuli during the tachycardia defined ventricular refractory and excitable periods. Within the ventricular excitable period there was a critical time interval during which stimulation produced premature ventricular depolarization and abrupt termination of the tachycardia. These findings support the hypothesis that junctional tachycardias in the absence of the Wolf-Parkinson-White syndrome may be sustained by reentry mechanisms. Moreover, right ventricular stimulation may be a valuable therapeutic adjunct in the treatment of such tachycardias.

Key Words: Heart block • Bradycardia • Reentry mechanisms