Retrograde ventriculoatrial jump—What is the mechanism?

During ventricular extra stimuli(VES) protocol a VA jump was noted. In upper panel with VES @ 500/270 ms (Fig A) the His signal appeared after the A‐EGM, ruling out pure nodal VA conduction and confirming presence of an accessory pathway (AP). The H signal was delayed due to probable retrograde RBBB...

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Detalles Bibliográficos
Autores principales: Bera, Debabrata, Majumder, Suchit, Choudhury, Saroj Kumar, Mukherjee, Sanjeev S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2023
Materias:
Spotlight
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10407172/
https://www.ncbi.nlm.nih.gov/pubmed/37560276
http://dx.doi.org/10.1002/joa3.12873
Descripción
Sumario:During ventricular extra stimuli(VES) protocol a VA jump was noted. In upper panel with VES @ 500/270 ms (Fig A) the His signal appeared after the A‐EGM, ruling out pure nodal VA conduction and confirming presence of an accessory pathway (AP). The H signal was delayed due to probable retrograde RBBB. The atrium was already depolarised via AP and the VA traversing via left bundle‐His‐node got blocked with a H signal. In the lower panel with VES of 500/260 ms the retrograde AP conduction reached the effective refractory period and pure nodal VA conduction took place along with retrograde RBBB. The retrograde VA jump was hence due to a jump from AP to AV node. [Image: see text]

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