Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome
Identifieur interne : 000860 ( Main/Corpus ); précédent : 000859; suivant : 000861Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome
Auteurs : Kazushi Tanaka ; Fumio Suzuki ; Kazumasa Hiejima ; Osamu FujimuraSource :
- Pacing and Clinical Electrophysiology [ 0147-8389 ] ; 1997-05.
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Abstract
Concealed conduction is demonstrated to occur in an accessory AV pathway (AP). To test the hypothesis that anterograde and retrograde concealed conduction in the AP would have different characteristics, 35 consecutive patients with single APs were studied. The anterograde or retrograde ERP of the AP could be determined in 23 of those patients. Anterograde concealed conduction in the AP was assessed in the first 13 patients with retrograde AP conduction (8 APs with retrograde conduction only and 5 with both directions) (group A). Retrograde concealed conduction in the AP was evaluated in the remaining 10 patients with anterograde AP conduction (6 APs with anterograde conduction only and 4 with both directions) (group B). The concealed conduction in the AP was quantified by determining the ERP of the AP using a “probe” extrastimulus (Sp) introduced in the opposite chamber. The ERP was determined both during conventional extrastimulus (S1S2 method; ERPc) and during that with an Sp (S1SpS2 method; ERPp). The Sp was delivered before or after the last S1 with various S1Sp intervals. The ERPp was determined at each S1Sp interval. Three distinct patterns in concealed conduction in the AP were noted. In the first pattern, the ERPp was always shorter than the ERPc, whereas the reverse relation was noted in the second pattern. The third pattern showed a combination of the two. In group A, only the first pattern was noted. In group B, the first, second, and third patterns were noted in 4, 2, and 4 patients, respectively. The first pattern was noted only in septal APs and the second and third were seen only in left free‐wall APs. The second pattern was seen in patients with retrograde AP conduction, whereas the third one was mainly noted in patients without retrograde AP conduction. These observations indicate that anterograde and retrograde concealed conduction in the AP have different characteristics. Shortening of the ERPp might be due to the “peeling back” phenomenon, and its lengthening might be caused by the presence of the inhomogeneous refractory periods of the AP. (PACE 1997; 20[Pt. I]:1342‐1353)
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DOI: 10.1111/j.1540-8159.1997.tb06789.x
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<record><TEI wicri:istexFullTextTei="biblStruct"><teiHeader><fileDesc><titleStmt><title xml:lang="en">Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title><author><name sortKey="Tanaka, Kazushi" sort="Tanaka, Kazushi" uniqKey="Tanaka K" first="Kazushi" last="Tanaka">Kazushi Tanaka</name><affiliation><mods:affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</mods:affiliation></affiliation></author><author><name sortKey="Suzuki, Fumio" sort="Suzuki, Fumio" uniqKey="Suzuki F" first="Fumio" last="Suzuki">Fumio Suzuki</name><affiliation><mods:affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</mods:affiliation></affiliation></author><author><name sortKey="Hiejima, Kazumasa" sort="Hiejima, Kazumasa" uniqKey="Hiejima K" first="Kazumasa" last="Hiejima">Kazumasa Hiejima</name><affiliation><mods:affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</mods:affiliation></affiliation></author><author><name sortKey="Fujimura, Osamu" sort="Fujimura, Osamu" uniqKey="Fujimura O" first="Osamu" last="Fujimura">Osamu Fujimura</name><affiliation><mods:affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:245B903B9068C623D7F3EE60AE6E60EE4E81483F</idno><date when="1997" year="1997">1997</date><idno type="doi">10.1111/j.1540-8159.1997.tb06789.x</idno><idno type="url">https://api.istex.fr/document/245B903B9068C623D7F3EE60AE6E60EE4E81483F/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000860</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title><author><name sortKey="Tanaka, Kazushi" sort="Tanaka, Kazushi" uniqKey="Tanaka K" first="Kazushi" last="Tanaka">Kazushi Tanaka</name><affiliation><mods:affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</mods:affiliation></affiliation><affiliation><mods:affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</mods:affiliation></affiliation></author><author><name sortKey="Suzuki, Fumio" sort="Suzuki, Fumio" uniqKey="Suzuki F" first="Fumio" last="Suzuki">Fumio Suzuki</name><affiliation><mods:affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</mods:affiliation></affiliation></author><author><name sortKey="Hiejima, Kazumasa" sort="Hiejima, Kazumasa" uniqKey="Hiejima K" first="Kazumasa" last="Hiejima">Kazumasa Hiejima</name><affiliation><mods:affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</mods:affiliation></affiliation></author><author><name sortKey="Fujimura, Osamu" sort="Fujimura, Osamu" uniqKey="Fujimura O" first="Osamu" last="Fujimura">Osamu Fujimura</name><affiliation><mods:affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">Pacing and Clinical Electrophysiology</title><idno type="ISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1997-05">1997-05</date><biblScope unit="volume">20</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="1342">1342</biblScope><biblScope unit="page" to="1353">1353</biblScope></imprint><idno type="ISSN">0147-8389</idno></series><idno type="istex">245B903B9068C623D7F3EE60AE6E60EE4E81483F</idno><idno type="DOI">10.1111/j.1540-8159.1997.tb06789.x</idno><idno type="ArticleID">PACE1342</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0147-8389</idno></seriesStmt></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>accessory atrioventricular pathway</term><term>concealed conduction</term><term>peeling back phenomenon</term><term>rate dependent conduction properties</term><term>“probe” extrastimulus method</term></keywords></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Concealed conduction is demonstrated to occur in an accessory AV pathway (AP). To test the hypothesis that anterograde and retrograde concealed conduction in the AP would have different characteristics, 35 consecutive patients with single APs were studied. The anterograde or retrograde ERP of the AP could be determined in 23 of those patients. Anterograde concealed conduction in the AP was assessed in the first 13 patients with retrograde AP conduction (8 APs with retrograde conduction only and 5 with both directions) (group A). Retrograde concealed conduction in the AP was evaluated in the remaining 10 patients with anterograde AP conduction (6 APs with anterograde conduction only and 4 with both directions) (group B). The concealed conduction in the AP was quantified by determining the ERP of the AP using a “probe” extrastimulus (Sp) introduced in the opposite chamber. The ERP was determined both during conventional extrastimulus (S1S2 method; ERPc) and during that with an Sp (S1SpS2 method; ERPp). The Sp was delivered before or after the last S1 with various S1Sp intervals. The ERPp was determined at each S1Sp interval. Three distinct patterns in concealed conduction in the AP were noted. In the first pattern, the ERPp was always shorter than the ERPc, whereas the reverse relation was noted in the second pattern. The third pattern showed a combination of the two. In group A, only the first pattern was noted. In group B, the first, second, and third patterns were noted in 4, 2, and 4 patients, respectively. The first pattern was noted only in septal APs and the second and third were seen only in left free‐wall APs. The second pattern was seen in patients with retrograde AP conduction, whereas the third one was mainly noted in patients without retrograde AP conduction. These observations indicate that anterograde and retrograde concealed conduction in the AP have different characteristics. Shortening of the ERPp might be due to the “peeling back” phenomenon, and its lengthening might be caused by the presence of the inhomogeneous refractory periods of the AP. (PACE 1997; 20[Pt. I]:1342‐1353)</div></front></TEI><istex><corpusName>wiley</corpusName><author><json:item><name>KAZUSHI TANAKA</name><affiliations><json:string>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</json:string><json:string>Cardiology Division, Department of Medicine, University of California, San Diego, California</json:string></affiliations></json:item><json:item><name>FUMIO SUZUKI</name><affiliations><json:string>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</json:string></affiliations></json:item><json:item><name>KAZUMASA HIEJIMA</name><affiliations><json:string>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</json:string></affiliations></json:item><json:item><name>OSAMU FUJIMURA</name><affiliations><json:string>Cardiology Division, Department of Medicine, University of California, San Diego, California</json:string></affiliations></json:item></author><subject><json:item><lang><json:string>eng</json:string></lang><value>accessory atrioventricular pathway</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>concealed conduction</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>“probe” extrastimulus method</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>peeling back phenomenon</value></json:item><json:item><lang><json:string>eng</json:string></lang><value>rate dependent conduction properties</value></json:item></subject><articleId><json:string>PACE1342</json:string></articleId><language><json:string>eng</json:string></language><abstract>Concealed conduction is demonstrated to occur in an accessory AV pathway (AP). To test the hypothesis that anterograde and retrograde concealed conduction in the AP would have different characteristics, 35 consecutive patients with single APs were studied. The anterograde or retrograde ERP of the AP could be determined in 23 of those patients. Anterograde concealed conduction in the AP was assessed in the first 13 patients with retrograde AP conduction (8 APs with retrograde conduction only and 5 with both directions) (group A). Retrograde concealed conduction in the AP was evaluated in the remaining 10 patients with anterograde AP conduction (6 APs with anterograde conduction only and 4 with both directions) (group B). The concealed conduction in the AP was quantified by determining the ERP of the AP using a “probe” extrastimulus (Sp) introduced in the opposite chamber. The ERP was determined both during conventional extrastimulus (S1S2 method; ERPc) and during that with an Sp (S1SpS2 method; ERPp). The Sp was delivered before or after the last S1 with various S1Sp intervals. The ERPp was determined at each S1Sp interval. Three distinct patterns in concealed conduction in the AP were noted. In the first pattern, the ERPp was always shorter than the ERPc, whereas the reverse relation was noted in the second pattern. The third pattern showed a combination of the two. In group A, only the first pattern was noted. In group B, the first, second, and third patterns were noted in 4, 2, and 4 patients, respectively. The first pattern was noted only in septal APs and the second and third were seen only in left free‐wall APs. The second pattern was seen in patients with retrograde AP conduction, whereas the third one was mainly noted in patients without retrograde AP conduction. These observations indicate that anterograde and retrograde concealed conduction in the AP have different characteristics. Shortening of the ERPp might be due to the “peeling back” phenomenon, and its lengthening might be caused by the presence of the inhomogeneous refractory periods of the AP. (PACE 1997; 20[Pt. I]:1342‐1353)</abstract><qualityIndicators><score>9.5</score><pdfVersion>1.6</pdfVersion><pdfPageSize>564 x 792 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>5</keywordCount><abstractCharCount>2129</abstractCharCount><pdfWordCount>5012</pdfWordCount><pdfCharCount>32031</pdfCharCount><pdfPageCount>13</pdfPageCount><abstractWordCount>342</abstractWordCount></qualityIndicators><title>Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title><genre><json:string>article</json:string></genre><host><volume>20</volume><publisherId><json:string>PACE</json:string></publisherId><pages><total>12</total><last>1353</last><first>1342</first></pages><issn><json:string>0147-8389</json:string></issn><issue>5</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><eissn><json:string>1540-8159</json:string></eissn><title>Pacing and Clinical Electrophysiology</title><doi><json:string>10.1111/(ISSN)1540-8159</json:string></doi></host><publicationDate>1997</publicationDate><copyrightDate>1997</copyrightDate><doi><json:string>10.1111/j.1540-8159.1997.tb06789.x</json:string></doi><id>245B903B9068C623D7F3EE60AE6E60EE4E81483F</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/245B903B9068C623D7F3EE60AE6E60EE4E81483F/fulltext/pdf</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/245B903B9068C623D7F3EE60AE6E60EE4E81483F/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/245B903B9068C623D7F3EE60AE6E60EE4E81483F/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><availability><p>WILEY</p></availability><date>1997</date></publicationStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title><author><persName><forename type="first">KAZUSHI</forename><surname>TANAKA</surname></persName><affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</affiliation><affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</affiliation></author><author><persName><forename type="first">FUMIO</forename><surname>SUZUKI</surname></persName><note type="correspondence"><p>Correspondence: Address for reprints: Fumio Suzuki, M.D., First Dept. of Internal Medicine, School of Medicine, Tokyo Medical and Dental University, 1‐5‐45 Yushima, Bunkyo‐ku, Tokyo, Japan, 113. Fax: 81‐3‐3818‐0448.</p></note><affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</affiliation></author><author><persName><forename type="first">KAZUMASA</forename><surname>HIEJIMA</surname></persName><affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</affiliation></author><author><persName><forename type="first">OSAMU</forename><surname>FUJIMURA</surname></persName><affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</affiliation></author></analytic><monogr><title level="j">Pacing and Clinical Electrophysiology</title><idno type="pISSN">0147-8389</idno><idno type="eISSN">1540-8159</idno><idno type="DOI">10.1111/(ISSN)1540-8159</idno><imprint><publisher>Blackwell Publishing Ltd</publisher><pubPlace>Oxford, UK</pubPlace><date type="published" when="1997-05"></date><biblScope unit="volume">20</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="1342">1342</biblScope><biblScope unit="page" to="1353">1353</biblScope></imprint></monogr><idno type="istex">245B903B9068C623D7F3EE60AE6E60EE4E81483F</idno><idno type="DOI">10.1111/j.1540-8159.1997.tb06789.x</idno><idno type="ArticleID">PACE1342</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1997</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Concealed conduction is demonstrated to occur in an accessory AV pathway (AP). To test the hypothesis that anterograde and retrograde concealed conduction in the AP would have different characteristics, 35 consecutive patients with single APs were studied. The anterograde or retrograde ERP of the AP could be determined in 23 of those patients. Anterograde concealed conduction in the AP was assessed in the first 13 patients with retrograde AP conduction (8 APs with retrograde conduction only and 5 with both directions) (group A). Retrograde concealed conduction in the AP was evaluated in the remaining 10 patients with anterograde AP conduction (6 APs with anterograde conduction only and 4 with both directions) (group B). The concealed conduction in the AP was quantified by determining the ERP of the AP using a “probe” extrastimulus (Sp) introduced in the opposite chamber. The ERP was determined both during conventional extrastimulus (S1S2 method; ERPc) and during that with an Sp (S1SpS2 method; ERPp). The Sp was delivered before or after the last S1 with various S1Sp intervals. The ERPp was determined at each S1Sp interval. Three distinct patterns in concealed conduction in the AP were noted. In the first pattern, the ERPp was always shorter than the ERPc, whereas the reverse relation was noted in the second pattern. The third pattern showed a combination of the two. In group A, only the first pattern was noted. In group B, the first, second, and third patterns were noted in 4, 2, and 4 patients, respectively. The first pattern was noted only in septal APs and the second and third were seen only in left free‐wall APs. The second pattern was seen in patients with retrograde AP conduction, whereas the third one was mainly noted in patients without retrograde AP conduction. These observations indicate that anterograde and retrograde concealed conduction in the AP have different characteristics. Shortening of the ERPp might be due to the “peeling back” phenomenon, and its lengthening might be caused by the presence of the inhomogeneous refractory periods of the AP. (PACE 1997; 20[Pt. I]:1342‐1353)</p></abstract><textClass xml:lang="en"><keywords scheme="keyword"><list><head>Keywords</head><item><term>accessory atrioventricular pathway</term></item><item><term>concealed conduction</term></item><item><term>“probe” extrastimulus method</term></item><item><term>peeling back phenomenon</term></item><item><term>rate dependent conduction properties</term></item></list></keywords></textClass></profileDesc><revisionDesc><change when="1997-05">Published</change></revisionDesc></teiHeader></istex:fulltextTEI><json:item><original>false</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/245B903B9068C623D7F3EE60AE6E60EE4E81483F/fulltext/txt</uri></json:item></fulltext><metadata><istex:metadataXml wicri:clean="Wiley, elements deleted: body"><istex:xmlDeclaration>version="1.0" encoding="UTF-8" standalone="yes"</istex:xmlDeclaration><istex:document><component version="2.0" type="serialArticle" xml:lang="en"><header><publicationMeta level="product"><publisherInfo><publisherName>Blackwell Publishing Ltd</publisherName><publisherLoc>Oxford, UK</publisherLoc></publisherInfo><doi origin="wiley" registered="yes">10.1111/(ISSN)1540-8159</doi><issn type="print">0147-8389</issn><issn type="electronic">1540-8159</issn><idGroup><id type="product" value="PACE"></id><id type="publisherDivision" value="ST"></id></idGroup><titleGroup><title type="main" sort="PACING CLINICAL ELECTROPHYSIOLOGY">Pacing and Clinical Electrophysiology</title></titleGroup></publicationMeta><publicationMeta level="part" position="05005"><doi origin="wiley">10.1111/pace.1997.20.issue-5</doi><numberingGroup><numbering type="journalVolume" number="20">20</numbering><numbering type="journalIssue" number="5">5</numbering></numberingGroup><coverDate startDate="1997-05">May 1997</coverDate></publicationMeta><publicationMeta level="unit" type="article" position="0134200" status="forIssue"><doi origin="wiley">10.1111/j.1540-8159.1997.tb06789.x</doi><idGroup><id type="unit" value="PACE1342"></id></idGroup><countGroup><count type="pageTotal" number="12"></count></countGroup><eventGroup><event type="firstOnline" date="2006-06-30"></event><event type="publishedOnlineFinalForm" date="2006-06-30"></event><event type="xmlConverted" agent="Converter:BPG_TO_WML3G version:2.3.2 mode:FullText source:HeaderRef result:HeaderRef" date="2010-03-02"></event><event type="xmlConverted" agent="Converter:WILEY_ML3G_TO_WILEY_ML3GV2 version:3.8.8" date="2014-02-06"></event><event type="xmlConverted" agent="Converter:WML3G_To_WML3G version:4.1.7 mode:FullText,remove_FC" date="2014-11-03"></event></eventGroup><numberingGroup><numbering type="pageFirst" number="1342">1342</numbering><numbering type="pageLast" number="1353">1353</numbering></numberingGroup><correspondenceTo>Address for reprints: Fumio Suzuki, M.D., First Dept. of Internal Medicine, School of Medicine, Tokyo Medical and Dental University, 1‐5‐45 Yushima, Bunkyo‐ku, Tokyo, Japan, 113. Fax: 81‐3‐3818‐0448.</correspondenceTo><linkGroup><link type="toTypesetVersion" href="file:PACE.PACE1342.pdf"></link></linkGroup></publicationMeta><contentMeta><unparsedEditorialHistory>Received July 14, 1995; revision November 9, 1995; accepted January 23, 1996.</unparsedEditorialHistory><countGroup><count type="referenceTotal" number="37"></count><count type="linksCrossRef" number="6"></count></countGroup><titleGroup><title type="main">Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title></titleGroup><creators><creator creatorRole="author" xml:id="cr1" affiliationRef="#a1 #a2"><personName><givenNames>KAZUSHI</givenNames><familyName>TANAKA</familyName></personName></creator><creator creatorRole="author" xml:id="cr2" affiliationRef="#a1" corresponding="yes"><personName><givenNames>FUMIO</givenNames><familyName>SUZUKI</familyName></personName></creator><creator creatorRole="author" xml:id="cr3" affiliationRef="#a1"><personName><givenNames>KAZUMASA</givenNames><familyName>HIEJIMA</familyName></personName></creator><creator creatorRole="author" xml:id="cr4" affiliationRef="#a2"><personName><givenNames>OSAMU</givenNames><familyName>FUJIMURA</familyName></personName></creator></creators><affiliationGroup><affiliation xml:id="a1" countryCode="JP"><unparsedAffiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</unparsedAffiliation></affiliation><affiliation xml:id="a2" countryCode="US"><unparsedAffiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</unparsedAffiliation></affiliation></affiliationGroup><keywordGroup xml:lang="en"><keyword xml:id="k1">accessory atrioventricular pathway</keyword><keyword xml:id="k2">concealed conduction</keyword><keyword xml:id="k3">“probe” extrastimulus method</keyword><keyword xml:id="k4">peeling back phenomenon</keyword><keyword xml:id="k5">rate dependent conduction properties</keyword></keywordGroup><abstractGroup><abstract type="main" xml:lang="en"><p>Concealed conduction is demonstrated to occur in an accessory AV pathway (AP). To test the hypothesis that anterograde and retrograde concealed conduction in the AP would have different characteristics, 35 consecutive patients with single APs were studied. The anterograde or retrograde ERP of the AP could be determined in 23 of those patients. Anterograde concealed conduction in the AP was assessed in the first 13 patients with retrograde AP conduction (8 APs with retrograde conduction only and 5 with both directions) (group A). Retrograde concealed conduction in the AP was evaluated in the remaining 10 patients with anterograde AP conduction (6 APs with anterograde conduction only and 4 with both directions) (group B). The concealed conduction in the AP was quantified by determining the ERP of the AP using a “probe” extrastimulus (S<sub>p</sub>) introduced in the opposite chamber. The ERP was determined both during conventional extrastimulus (S<sub>1</sub>S<sub>2</sub> method; ERP<sub>c</sub>) and during that with an S<sub>p</sub> (S<sub>1</sub>S<sub>p</sub>S<sub>2</sub> method; ERP<sub>p</sub>). The S<sub>p</sub> was delivered before or after the last S<sub>1</sub> with various S<sub>1</sub>S<sub>p</sub> intervals. The ERP<sub>p</sub> was determined at each S<sub>1</sub>S<sub>p</sub> interval. Three distinct patterns in concealed conduction in the AP were noted. In the first pattern, the ERP<sub>p</sub> was always shorter than the ERP<sub>c</sub>, whereas the reverse relation was noted in the second pattern. The third pattern showed a combination of the two. In group A, only the first pattern was noted. In group B, the first, second, and third patterns were noted in 4, 2, and 4 patients, respectively. The first pattern was noted only in septal APs and the second and third were seen only in left free‐wall APs. The second pattern was seen in patients with retrograde AP conduction, whereas the third one was mainly noted in patients without retrograde AP conduction. These observations indicate that anterograde and retrograde concealed conduction in the AP have different characteristics. Shortening of the ERP<sub>p</sub> might be due to the “peeling back” phenomenon, and its lengthening might be caused by the presence of the inhomogeneous refractory periods of the AP. (PACE 1997; 20[Pt. I]:1342‐1353)</p></abstract></abstractGroup></contentMeta></header></component></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title></titleInfo><titleInfo type="alternative" contentType="CDATA" lang="en"><title>Quantitative Analysis of Concealed Conduction into Accessory Atrioventricular Pathways in Wolff‐Parkinson‐White Syndrome</title></titleInfo><name type="personal"><namePart type="given">KAZUSHI</namePart><namePart type="family">TANAKA</namePart><affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</affiliation><affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">FUMIO</namePart><namePart type="family">SUZUKI</namePart><affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</affiliation><description>Correspondence: Address for reprints: Fumio Suzuki, M.D., First Dept. of Internal Medicine, School of Medicine, Tokyo Medical and Dental University, 1‐5‐45 Yushima, Bunkyo‐ku, Tokyo, Japan, 113. Fax: 81‐3‐3818‐0448.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">KAZUMASA</namePart><namePart type="family">HIEJIMA</namePart><affiliation>First Department of Internal Medicine, Tokyo Medical and Dental University, Tokyo, Japan</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">OSAMU</namePart><namePart type="family">FUJIMURA</namePart><affiliation>Cardiology Division, Department of Medicine, University of California, San Diego, California</affiliation><role><roleTerm type="text">author</roleTerm></role></name><typeOfResource>text</typeOfResource><genre type="article" displayLabel="article"></genre><originInfo><publisher>Blackwell Publishing Ltd</publisher><place><placeTerm type="text">Oxford, UK</placeTerm></place><dateIssued encoding="w3cdtf">1997-05</dateIssued><edition>Received July 14, 1995; revision November 9, 1995; accepted January 23, 1996.</edition><copyrightDate encoding="w3cdtf">1997</copyrightDate></originInfo><language><languageTerm type="code" authority="rfc3066">en</languageTerm><languageTerm type="code" authority="iso639-2b">eng</languageTerm></language><physicalDescription><internetMediaType>text/html</internetMediaType><extent unit="references">37</extent></physicalDescription><abstract lang="en">Concealed conduction is demonstrated to occur in an accessory AV pathway (AP). To test the hypothesis that anterograde and retrograde concealed conduction in the AP would have different characteristics, 35 consecutive patients with single APs were studied. The anterograde or retrograde ERP of the AP could be determined in 23 of those patients. Anterograde concealed conduction in the AP was assessed in the first 13 patients with retrograde AP conduction (8 APs with retrograde conduction only and 5 with both directions) (group A). Retrograde concealed conduction in the AP was evaluated in the remaining 10 patients with anterograde AP conduction (6 APs with anterograde conduction only and 4 with both directions) (group B). The concealed conduction in the AP was quantified by determining the ERP of the AP using a “probe” extrastimulus (Sp) introduced in the opposite chamber. The ERP was determined both during conventional extrastimulus (S1S2 method; ERPc) and during that with an Sp (S1SpS2 method; ERPp). The Sp was delivered before or after the last S1 with various S1Sp intervals. The ERPp was determined at each S1Sp interval. Three distinct patterns in concealed conduction in the AP were noted. In the first pattern, the ERPp was always shorter than the ERPc, whereas the reverse relation was noted in the second pattern. The third pattern showed a combination of the two. In group A, only the first pattern was noted. In group B, the first, second, and third patterns were noted in 4, 2, and 4 patients, respectively. The first pattern was noted only in septal APs and the second and third were seen only in left free‐wall APs. The second pattern was seen in patients with retrograde AP conduction, whereas the third one was mainly noted in patients without retrograde AP conduction. These observations indicate that anterograde and retrograde concealed conduction in the AP have different characteristics. Shortening of the ERPp might be due to the “peeling back” phenomenon, and its lengthening might be caused by the presence of the inhomogeneous refractory periods of the AP. (PACE 1997; 20[Pt. I]:1342‐1353)</abstract><subject lang="en"><genre>Keywords</genre><topic>accessory atrioventricular pathway</topic><topic>concealed conduction</topic><topic>“probe” extrastimulus method</topic><topic>peeling back phenomenon</topic><topic>rate dependent conduction properties</topic></subject><relatedItem type="host"><titleInfo><title>Pacing and Clinical Electrophysiology</title></titleInfo><genre type="Journal">journal</genre><identifier type="ISSN">0147-8389</identifier><identifier type="eISSN">1540-8159</identifier><identifier type="DOI">10.1111/(ISSN)1540-8159</identifier><identifier type="PublisherID">PACE</identifier><part><date>1997</date><detail type="volume"><caption>vol.</caption><number>20</number></detail><detail type="issue"><caption>no.</caption><number>5</number></detail><extent unit="pages"><start>1342</start><end>1353</end><total>12</total></extent></part></relatedItem><identifier type="istex">245B903B9068C623D7F3EE60AE6E60EE4E81483F</identifier><identifier type="DOI">10.1111/j.1540-8159.1997.tb06789.x</identifier><identifier type="ArticleID">PACE1342</identifier><recordInfo><recordContentSource>WILEY</recordContentSource><recordOrigin>Blackwell Publishing Ltd</recordOrigin></recordInfo></mods></metadata><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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