A Reappraisal of Atrioventricular Nodal Excitability During Functional 2:1 Block: What Should be the Gauge?†

  1. MING-LON YOUNG*

Article first published online: 5 OCT 2007

DOI: 10.1111/j.1540-8159.1990.tb06869.x

Issue

Pacing and Clinical Electrophysiology

Pacing and Clinical Electrophysiology

Volume 13, Issue 12, pages 1666–1673, December 1990

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How to Cite

YOUNG, M.-L. (1990), A Reappraisal of Atrioventricular Nodal Excitability During Functional 2:1 Block: What Should be the Gauge?. Pacing and Clinical Electrophysiology, 13: 1666–1673. doi: 10.1111/j.1540-8159.1990.tb06869.x

Author Information

  1. The Department of Pediatrics, National Taiwan University, Taipei, Taiwan

*2 Department of Pediatrics, National Taiwan University Hospital, No. 1, Chang-Te Street, Taipei, 10016, Taiwan

  1. †

    *An editorial by Lehmann et al follows this article.

Publication History

  1. Issue published online: 5 OCT 2007
  2. Article first published online: 5 OCT 2007
  3. Received February 2, 1990; revision April 20, 1990; accepted May 29, 1990

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Keywords:

  • refractory periods;
  • conduction

YOUNG, M.-L.: A Reappraisal of Atrioventricular Nodal Excitability During Functional 2:1 Block: What Should be the Gauge? By using extrastimulation technique the effective refractory period (ERP) of the atrioventricular (AV) node is conventionally defined as the longest A1 A2 interval at which conduction of A2 is blocked within the node. With the prolongation of the AV nodal transit time that is associated with this technique, the delayed AV nodal arrival of the A1 impulse will cause an overestimation of the true interval if the A1 A2 interval is used as the gauge. Under this condition, the conventional approach will not accurately delineate the ERP of the AV node. However, this prolongation of the nodal transit time can be calculated by subtracting the basal conduction time from the conducted A-H interval. By subtracting out the prolongation from the longest A1 A2 at which A2 impulse is blocked, not only an interval more indicative of the true AV nodal ERP can be obtained, but also the apparent discrepancies between the in vitro and human AV nodal recovery curves disappear.

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