Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome
Identifieur interne : 000099 ( Main/Corpus ); précédent : 000098; suivant : 000100Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome
Auteurs : Rashid A. Massumi ; Zakauddi VeraSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1971.
Abstract
Normalization of QRS complexes in Wolff-Parkinson-White syndrome reflecting exclusive conduction through the atrioventricular node-His axis was investigated in 17 cases. The study was prompted by the frequent observation of disappearance of delta waves in a variety of circumstances in such cases. The study consisted mainly of recording of His bundle potentials at rest and during spontaneous and induced supraventricular premature beats and tachycardias. Normalization occurred in 11 cases, and the mechanisms followed several patterns. Generally, QRS complexes became normal in the following circumstances: (1) when the accessory path failed to conduct at very high atrial rates and also with very early premature beats; (2) the accessory path became refractory by virtue of phase 4 depolarization after long pauses and in slow rhythm; (3) when the origin of the ventricular impulse was situated within the His bundle below the take-off of the accessory path; and (4) in circumstances in which conduction velocity through the atrioventricular node-His axis superceded that of the accessory path.It is suggested that a thorough understanding of the mechanisms involved in the normalization of QRS in Wolff-Parkinson-White syndrome is essential to the appreciation of the electrophysiologic features of this syndrome.
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DOI: 10.1016/0002-9149(71)90096-8
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USA</mods:affiliation></affiliation></author><author><name sortKey="Vera, Zakauddi" sort="Vera, Zakauddi" uniqKey="Vera Z" first="Zakauddi" last="Vera">Zakauddi Vera</name><affiliation><mods:affiliation>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. 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The study was prompted by the frequent observation of disappearance of delta waves in a variety of circumstances in such cases. The study consisted mainly of recording of His bundle potentials at rest and during spontaneous and induced supraventricular premature beats and tachycardias. Normalization occurred in 11 cases, and the mechanisms followed several patterns. Generally, QRS complexes became normal in the following circumstances: (1) when the accessory path failed to conduct at very high atrial rates and also with very early premature beats; (2) the accessory path became refractory by virtue of phase 4 depolarization after long pauses and in slow rhythm; (3) when the origin of the ventricular impulse was situated within the His bundle below the take-off of the accessory path; and (4) in circumstances in which conduction velocity through the atrioventricular node-His axis superceded that of the accessory path.It is suggested that a thorough understanding of the mechanisms involved in the normalization of QRS in Wolff-Parkinson-White syndrome is essential to the appreciation of the electrophysiologic features of this syndrome.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Rashid A. Massumi MD, FACC</name><affiliations><json:string>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. USA</json:string></affiliations></json:item><json:item><name>Zakauddi Vera MB</name><affiliations><json:string>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. USA</json:string></affiliations></json:item></author><articleId><json:string>71900968</json:string></articleId><language><json:string>eng</json:string></language><abstract>Normalization of QRS complexes in Wolff-Parkinson-White syndrome reflecting exclusive conduction through the atrioventricular node-His axis was investigated in 17 cases. The study was prompted by the frequent observation of disappearance of delta waves in a variety of circumstances in such cases. The study consisted mainly of recording of His bundle potentials at rest and during spontaneous and induced supraventricular premature beats and tachycardias. Normalization occurred in 11 cases, and the mechanisms followed several patterns. Generally, QRS complexes became normal in the following circumstances: (1) when the accessory path failed to conduct at very high atrial rates and also with very early premature beats; (2) the accessory path became refractory by virtue of phase 4 depolarization after long pauses and in slow rhythm; (3) when the origin of the ventricular impulse was situated within the His bundle below the take-off of the accessory path; and (4) in circumstances in which conduction velocity through the atrioventricular node-His axis superceded that of the accessory path.It is suggested that a thorough understanding of the mechanisms involved in the normalization of QRS in Wolff-Parkinson-White syndrome is essential to the appreciation of the electrophysiologic features of this syndrome.</abstract><qualityIndicators><score>7.304</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612 x 828 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1318</abstractCharCount><pdfWordCount>5385</pdfWordCount><pdfCharCount>37864</pdfCharCount><pdfPageCount>14</pdfPageCount><abstractWordCount>192</abstractWordCount></qualityIndicators><title>Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome</title><pii><json:string>0002-9149(71)90096-8</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>28</volume><pii><json:string>S0002-9149(00)X0478-X</json:string></pii><pages><last>554</last><first>541</first></pages><issn><json:string>0002-9149</json:string></issn><issue>5</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>The American Journal of Cardiology</title><publicationDate>1971</publicationDate></host><publicationDate>1971</publicationDate><copyrightDate>1971</copyrightDate><doi><json:string>10.1016/0002-9149(71)90096-8</json:string></doi><id>04B16C97856699FBF2146A781A46E7383AC9C002</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/04B16C97856699FBF2146A781A46E7383AC9C002/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/04B16C97856699FBF2146A781A46E7383AC9C002/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/04B16C97856699FBF2146A781A46E7383AC9C002/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/04B16C97856699FBF2146A781A46E7383AC9C002/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1971</date></publicationStmt><notesStmt><note type="content">Section title: Clinical study</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome</title><author><persName><forename type="first">Rashid A.</forename><surname>Massumi</surname></persName><roleName type="degree">MD, FACC</roleName><note type="biography">Present address and address for reprints: Rashid A. Massumi MD, Section of Cardiovascular Medicine, University of California at Davis, Davis, Calif. 95616.</note><affiliation>Present address and address for reprints: Rashid A. Massumi MD, Section of Cardiovascular Medicine, University of California at Davis, Davis, Calif. 95616.</affiliation><affiliation>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. USA</affiliation></author><author><persName><forename type="first">Zakauddi</forename><surname>Vera</surname></persName><roleName type="degree">MB</roleName><affiliation>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. USA</affiliation></author></analytic><monogr><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="pISSN">0002-9149</idno><idno type="PII">S0002-9149(00)X0478-X</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1971"></date><biblScope unit="volume">28</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="541">541</biblScope><biblScope unit="page" to="554">554</biblScope></imprint></monogr><idno type="istex">04B16C97856699FBF2146A781A46E7383AC9C002</idno><idno type="DOI">10.1016/0002-9149(71)90096-8</idno><idno type="PII">0002-9149(71)90096-8</idno><idno type="ArticleID">71900968</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1971</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Normalization of QRS complexes in Wolff-Parkinson-White syndrome reflecting exclusive conduction through the atrioventricular node-His axis was investigated in 17 cases. The study was prompted by the frequent observation of disappearance of delta waves in a variety of circumstances in such cases. The study consisted mainly of recording of His bundle potentials at rest and during spontaneous and induced supraventricular premature beats and tachycardias. Normalization occurred in 11 cases, and the mechanisms followed several patterns. Generally, QRS complexes became normal in the following circumstances: (1) when the accessory path failed to conduct at very high atrial rates and also with very early premature beats; (2) the accessory path became refractory by virtue of phase 4 depolarization after long pauses and in slow rhythm; (3) when the origin of the ventricular impulse was situated within the His bundle below the take-off of the accessory path; and (4) in circumstances in which conduction velocity through the atrioventricular node-His axis superceded that of the accessory path.It is suggested that a thorough understanding of the mechanisms involved in the normalization of QRS in Wolff-Parkinson-White syndrome is essential to the appreciation of the electrophysiologic features of this syndrome.</p></abstract></profileDesc><revisionDesc><change when="1971-02-24">Registration</change><change when="1971-01-25">Modified</change><change when="1971">Published</change></revisionDesc></teiHeader></istex:fulltextTEI></fulltext><metadata><istex:metadataXml wicri:clean="Elsevier, elements deleted: tail"><istex:xmlDeclaration>version="1.0" encoding="UTF-8"</istex:xmlDeclaration><istex:docType PUBLIC="-//ES//DTD journal article DTD version 4.5.2//EN//XML" URI="art452.dtd" name="istex:docType"></istex:docType><istex:document><converted-article version="4.5.2" docsubtype="fla" xml:lang="en"><item-info><jid>AJC</jid><aid>71900968</aid><ce:pii>0002-9149(71)90096-8</ce:pii><ce:doi>10.1016/0002-9149(71)90096-8</ce:doi><ce:copyright type="unknown" year="1971"></ce:copyright></item-info><head><ce:dochead><ce:textfn>Clinical study</ce:textfn></ce:dochead><ce:title>Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome</ce:title><ce:author-group><ce:author><ce:given-name>Rashid A.</ce:given-name><ce:surname>Massumi</ce:surname><ce:degrees>MD, FACC</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Zakauddi</ce:given-name><ce:surname>Vera</ce:surname><ce:degrees>MB</ce:degrees></ce:author><ce:affiliation><ce:textfn>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Present address and address for reprints: Rashid A. Massumi MD, Section of Cardiovascular Medicine, University of California at Davis, Davis, Calif. 95616.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="22" month="12" year="1970"></ce:date-received><ce:date-revised day="25" month="1" year="1971"></ce:date-revised><ce:date-accepted day="24" month="2" year="1971"></ce:date-accepted><ce:abstract class="author"><ce:section-title>Abstract</ce:section-title><ce:abstract-sec><ce:simple-para view="all" id="simple-para.0010">Normalization of QRS complexes in Wolff-Parkinson-White syndrome reflecting exclusive conduction through the atrioventricular node-His axis was investigated in 17 cases. The study was prompted by the frequent observation of disappearance of delta waves in a variety of circumstances in such cases. The study consisted mainly of recording of His bundle potentials at rest and during spontaneous and induced supraventricular premature beats and tachycardias. Normalization occurred in 11 cases, and the mechanisms followed several patterns. Generally, QRS complexes became normal in the following circumstances: (1) when the accessory path failed to conduct at very high atrial rates and also with very early premature beats; (2) the accessory path became refractory by virtue of phase 4 depolarization after long pauses and in slow rhythm; (3) when the origin of the ventricular impulse was situated within the His bundle below the take-off of the accessory path; and (4) in circumstances in which conduction velocity through the atrioventricular node-His axis superceded that of the accessory path.</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">It is suggested that a thorough understanding of the mechanisms involved in the normalization of QRS in Wolff-Parkinson-White syndrome is essential to the appreciation of the electrophysiologic features of this syndrome.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Patterns and mechanisms of QRS normalization in patients with Wolff-Parkinson-White syndrome</title></titleInfo><name type="personal"><namePart type="given">Rashid A.</namePart><namePart type="family">Massumi</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. USA</affiliation><description>Present address and address for reprints: Rashid A. Massumi MD, Section of Cardiovascular Medicine, University of California at Davis, Davis, Calif. 95616.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Zakauddi</namePart><namePart type="family">Vera</namePart><namePart type="termsOfAddress">MB</namePart><affiliation>From the Cardiopulmonary-Angio Laboratory and the George Washington University Division of Medicine, District of Columbia General Hospital, Washington, D.C. USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="research-article" displayLabel="Full-length article"></genre><originInfo><publisher>ELSEVIER</publisher><dateIssued encoding="w3cdtf">1971</dateIssued><dateValid encoding="w3cdtf">1971-02-24</dateValid><dateModified encoding="w3cdtf">1971-01-25</dateModified><copyrightDate encoding="w3cdtf">1971</copyrightDate></originInfo><language><languageTerm type="code" authority="iso639-2b">eng</languageTerm><languageTerm type="code" authority="rfc3066">en</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType></physicalDescription><abstract lang="en">Normalization of QRS complexes in Wolff-Parkinson-White syndrome reflecting exclusive conduction through the atrioventricular node-His axis was investigated in 17 cases. The study was prompted by the frequent observation of disappearance of delta waves in a variety of circumstances in such cases. The study consisted mainly of recording of His bundle potentials at rest and during spontaneous and induced supraventricular premature beats and tachycardias. Normalization occurred in 11 cases, and the mechanisms followed several patterns. Generally, QRS complexes became normal in the following circumstances: (1) when the accessory path failed to conduct at very high atrial rates and also with very early premature beats; (2) the accessory path became refractory by virtue of phase 4 depolarization after long pauses and in slow rhythm; (3) when the origin of the ventricular impulse was situated within the His bundle below the take-off of the accessory path; and (4) in circumstances in which conduction velocity through the atrioventricular node-His axis superceded that of the accessory path.It is suggested that a thorough understanding of the mechanisms involved in the normalization of QRS in Wolff-Parkinson-White syndrome is essential to the appreciation of the electrophysiologic features of this syndrome.</abstract><note type="content">Section title: Clinical study</note><relatedItem type="host"><titleInfo><title>The American Journal of Cardiology</title></titleInfo><titleInfo type="abbreviated"><title>AJC</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">197111</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0478-X</identifier><part><date>197111</date><detail type="issue"><title>Symposium on Electophysiologic Correlates of Clinical Arrhythmias</title></detail><detail type="volume"><number>28</number><caption>vol.</caption></detail><detail type="issue"><number>5</number><caption>no.</caption></detail><extent unit="issue pages"><start>E1</start><end>E54</end></extent><extent unit="issue pages"><start>E59</start><end>E71</end></extent><extent unit="issue pages"><start>499</start><end>620</end></extent><extent unit="pages"><start>541</start><end>554</end></extent></part></relatedItem><identifier type="istex">04B16C97856699FBF2146A781A46E7383AC9C002</identifier><identifier type="DOI">10.1016/0002-9149(71)90096-8</identifier><identifier type="PII">0002-9149(71)90096-8</identifier><identifier type="ArticleID">71900968</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/04B16C97856699FBF2146A781A46E7383AC9C002/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><analytic><title level="a" type="main">Bundle branch block with short P-R interval in healthy young people prone to paroxysmal tachycardia</title><author><persName><forename type="middle">L</forename><surname>Wolff</surname></persName></author><author><persName><forename type="middle">J</forename><surname>Parkinson</surname></persName></author><author><persName><surname>White</surname></persName></author></analytic><monogr><title level="j">Amer Heart J</title><imprint><biblScope unit="volume">5</biblScope><biblScope unit="page" from="16815" to="704"></biblScope><date type="published" when="1930"></date></imprint></monogr></biblStruct><biblStruct><monogr><title level="m" type="main">The mechanism of production of short P-R intervals and prolonged QRS complexes in patients with presumably undamaged hearts. 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