Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle
Identifieur interne : 000907 ( Main/Corpus ); précédent : 000906; suivant : 000908Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle
Auteurs : Agustin Castellanos ; Ruey J. Sung ; Juan L. Aldrich ; Ivan J. Mendoza ; Robert J. MyerburgSource :
- The American Journal of Cardiology [ 0002-9149 ] ; 1977.
Abstract
Alternating Wenckebach periods were defined as episodes of 2:1 block during which there was a gradual prolongation of the transmission intervals preceding the appearance of 3:1 or 4:1 block. Alternating Wenckebach periods occurring within the His-Purkinje system in symptomatic patients with right bundle branch block could have resulted from involvement of the His bundle only, the left bundle branch only or both structures simultaneously. Alternating Wenckebach patterns presumably occurring in the reentry pathway of ventricular extrasystoles and in the tissues surrounding an ectopic atrial focus or bipolar pacing electrodes were manifested in the coupling intervals of the premature beats; in the P-P intervals of atrial tachycardia with atrioventricular (A-V) block due to digitalis; and in the stimulus (St)-A intervals following electrical stimuli delivered to the atria at fast rates. Alternating Wenckebach periods of St-H and St-delta wave intervals in patients with the Wolff-Parkinson-White syndrome resulted from involvement of the Kent bundle itself, or of the atria as a proximal level common to distal longitudinally dissociated structures (Kent bundle and A-V node).It is concluded that contrary to what is commonly believed alternating Wenckebach periods may be a tachycardia-dependent phenomenon occurring above, below or outside the A-V node and explaining a variety of spontaneous or electrically induced arrhythmias whose significance depends on the clinical setting in which they occur.
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DOI: 10.1016/0002-9149(77)90034-0
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Aldrich</name><affiliation><mods:affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Mendoza, Ivan J" sort="Mendoza, Ivan J" uniqKey="Mendoza I" first="Ivan J." last="Mendoza">Ivan J. Mendoza</name><affiliation><mods:affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Myerburg, Robert J" sort="Myerburg, Robert J" uniqKey="Myerburg R" first="Robert J." last="Myerburg">Robert J. 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Sung</name><affiliation><mods:affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Aldrich, Juan L" sort="Aldrich, Juan L" uniqKey="Aldrich J" first="Juan L." last="Aldrich">Juan L. Aldrich</name><affiliation><mods:affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Mendoza, Ivan J" sort="Mendoza, Ivan J" uniqKey="Mendoza I" first="Ivan J." last="Mendoza">Ivan J. Mendoza</name><affiliation><mods:affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</mods:affiliation></affiliation></author><author><name sortKey="Myerburg, Robert J" sort="Myerburg, Robert J" uniqKey="Myerburg R" first="Robert J." last="Myerburg">Robert J. Myerburg</name><affiliation><mods:affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">The American Journal of Cardiology</title><title level="j" type="abbrev">AJC</title><idno type="ISSN">0002-9149</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977">1977</date><biblScope unit="volume">40</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="853">853</biblScope><biblScope unit="page" to="859">859</biblScope></imprint><idno type="ISSN">0002-9149</idno></series><idno type="istex">CC56E81D62FBAE82E9766733B159D48B9D8905BC</idno><idno type="DOI">10.1016/0002-9149(77)90034-0</idno><idno type="PII">0002-9149(77)90034-0</idno><idno type="ArticleID">77900340</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-9149</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">Alternating Wenckebach periods were defined as episodes of 2:1 block during which there was a gradual prolongation of the transmission intervals preceding the appearance of 3:1 or 4:1 block. Alternating Wenckebach periods occurring within the His-Purkinje system in symptomatic patients with right bundle branch block could have resulted from involvement of the His bundle only, the left bundle branch only or both structures simultaneously. Alternating Wenckebach patterns presumably occurring in the reentry pathway of ventricular extrasystoles and in the tissues surrounding an ectopic atrial focus or bipolar pacing electrodes were manifested in the coupling intervals of the premature beats; in the P-P intervals of atrial tachycardia with atrioventricular (A-V) block due to digitalis; and in the stimulus (St)-A intervals following electrical stimuli delivered to the atria at fast rates. Alternating Wenckebach periods of St-H and St-delta wave intervals in patients with the Wolff-Parkinson-White syndrome resulted from involvement of the Kent bundle itself, or of the atria as a proximal level common to distal longitudinally dissociated structures (Kent bundle and A-V node).It is concluded that contrary to what is commonly believed alternating Wenckebach periods may be a tachycardia-dependent phenomenon occurring above, below or outside the A-V node and explaining a variety of spontaneous or electrically induced arrhythmias whose significance depends on the clinical setting in which they occur.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Agustin Castellanos MD, FACC</name><affiliations><json:string>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</json:string></affiliations></json:item><json:item><name>Ruey J. 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Alternating Wenckebach patterns presumably occurring in the reentry pathway of ventricular extrasystoles and in the tissues surrounding an ectopic atrial focus or bipolar pacing electrodes were manifested in the coupling intervals of the premature beats; in the P-P intervals of atrial tachycardia with atrioventricular (A-V) block due to digitalis; and in the stimulus (St)-A intervals following electrical stimuli delivered to the atria at fast rates. Alternating Wenckebach periods of St-H and St-delta wave intervals in patients with the Wolff-Parkinson-White syndrome resulted from involvement of the Kent bundle itself, or of the atria as a proximal level common to distal longitudinally dissociated structures (Kent bundle and A-V node).It is concluded that contrary to what is commonly believed alternating Wenckebach periods may be a tachycardia-dependent phenomenon occurring above, below or outside the A-V node and explaining a variety of spontaneous or electrically induced arrhythmias whose significance depends on the clinical setting in which they occur.</abstract><qualityIndicators><score>7.024</score><pdfVersion>1.2</pdfVersion><pdfPageSize>612 x 828 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1512</abstractCharCount><pdfWordCount>4420</pdfWordCount><pdfCharCount>29200</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>217</abstractWordCount></qualityIndicators><title>Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle</title><pii><json:string>0002-9149(77)90034-0</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>40</volume><pii><json:string>S0002-9149(00)X0508-5</json:string></pii><pages><last>859</last><first>853</first></pages><issn><json:string>0002-9149</json:string></issn><issue>6</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>The American Journal of Cardiology</title><publicationDate>1977</publicationDate></host><publicationDate>1977</publicationDate><copyrightDate>1977</copyrightDate><doi><json:string>10.1016/0002-9149(77)90034-0</json:string></doi><id>CC56E81D62FBAE82E9766733B159D48B9D8905BC</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/CC56E81D62FBAE82E9766733B159D48B9D8905BC/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/CC56E81D62FBAE82E9766733B159D48B9D8905BC/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/CC56E81D62FBAE82E9766733B159D48B9D8905BC/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/CC56E81D62FBAE82E9766733B159D48B9D8905BC/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1977</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">Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle</title><author><persName><forename type="first">Agustin</forename><surname>Castellanos</surname></persName><roleName type="degree">MD, FACC</roleName><note type="biography">Address for reprints: Agustin Castellanos, MD, Division of Cardiology, University of Miami School of Medicine, P.O. Box 520875, Miami, Florida 33152.</note><affiliation>Address for reprints: Agustin Castellanos, MD, Division of Cardiology, University of Miami School of Medicine, P.O. Box 520875, Miami, Florida 33152.</affiliation><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation></author><author><persName><forename type="first">Ruey J.</forename><surname>Sung</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation></author><author><persName><forename type="first">Juan L.</forename><surname>Aldrich</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation></author><author><persName><forename type="first">Ivan J.</forename><surname>Mendoza</surname></persName><roleName type="degree">MD</roleName><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation></author><author><persName><forename type="first">Robert J.</forename><surname>Myerburg</surname></persName><roleName type="degree">MD, FACC</roleName><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</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)X0508-5</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977"></date><biblScope unit="volume">40</biblScope><biblScope unit="issue">6</biblScope><biblScope unit="page" from="853">853</biblScope><biblScope unit="page" to="859">859</biblScope></imprint></monogr><idno type="istex">CC56E81D62FBAE82E9766733B159D48B9D8905BC</idno><idno type="DOI">10.1016/0002-9149(77)90034-0</idno><idno type="PII">0002-9149(77)90034-0</idno><idno type="ArticleID">77900340</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1977</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>Alternating Wenckebach periods were defined as episodes of 2:1 block during which there was a gradual prolongation of the transmission intervals preceding the appearance of 3:1 or 4:1 block. Alternating Wenckebach periods occurring within the His-Purkinje system in symptomatic patients with right bundle branch block could have resulted from involvement of the His bundle only, the left bundle branch only or both structures simultaneously. Alternating Wenckebach patterns presumably occurring in the reentry pathway of ventricular extrasystoles and in the tissues surrounding an ectopic atrial focus or bipolar pacing electrodes were manifested in the coupling intervals of the premature beats; in the P-P intervals of atrial tachycardia with atrioventricular (A-V) block due to digitalis; and in the stimulus (St)-A intervals following electrical stimuli delivered to the atria at fast rates. Alternating Wenckebach periods of St-H and St-delta wave intervals in patients with the Wolff-Parkinson-White syndrome resulted from involvement of the Kent bundle itself, or of the atria as a proximal level common to distal longitudinally dissociated structures (Kent bundle and A-V node).It is concluded that contrary to what is commonly believed alternating Wenckebach periods may be a tachycardia-dependent phenomenon occurring above, below or outside the A-V node and explaining a variety of spontaneous or electrically induced arrhythmias whose significance depends on the clinical setting in which they occur.</p></abstract></profileDesc><revisionDesc><change when="1977-06-22">Registration</change><change when="1977-06-22">Modified</change><change when="1977">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>77900340</aid><ce:pii>0002-9149(77)90034-0</ce:pii><ce:doi>10.1016/0002-9149(77)90034-0</ce:doi><ce:copyright type="unknown" year="1977"></ce:copyright></item-info><head><ce:dochead><ce:textfn>Clinical study</ce:textfn></ce:dochead><ce:title>Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle</ce:title><ce:author-group><ce:author><ce:given-name>Agustin</ce:given-name><ce:surname>Castellanos</ce:surname><ce:degrees>MD, FACC</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">∗</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF1"><ce:sup loc="post">1</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">2</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Ruey J.</ce:given-name><ce:surname>Sung</ce:surname><ce:degrees>MD, FACC</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">1</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">2</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Juan L.</ce:given-name><ce:surname>Aldrich</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">1</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">2</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Ivan J.</ce:given-name><ce:surname>Mendoza</ce:surname><ce:degrees>MD</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">1</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">2</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Robert J.</ce:given-name><ce:surname>Myerburg</ce:surname><ce:degrees>MD, FACC</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">1</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">2</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>From the Section of Electrophysiology, Jackson Memorial Hospital, Miami, Florida U.S.A.</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>∗</ce:label><ce:text>Address for reprints: Agustin Castellanos, MD, Division of Cardiology, University of Miami School of Medicine, P.O. Box 520875, Miami, Florida 33152.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="28" month="3" year="1977"></ce:date-received><ce:date-revised day="22" month="6" year="1977"></ce:date-revised><ce:date-accepted day="22" month="6" year="1977"></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">Alternating Wenckebach periods were defined as episodes of 2:1 block during which there was a gradual prolongation of the transmission intervals preceding the appearance of 3:1 or 4:1 block. Alternating Wenckebach periods occurring within the His-Purkinje system in symptomatic patients with right bundle branch block could have resulted from involvement of the His bundle only, the left bundle branch only or both structures simultaneously. Alternating Wenckebach patterns presumably occurring in the reentry pathway of ventricular extrasystoles and in the tissues surrounding an ectopic atrial focus or bipolar pacing electrodes were manifested in the coupling intervals of the premature beats; in the P-P intervals of atrial tachycardia with atrioventricular (A-V) block due to digitalis; and in the stimulus (St)-A intervals following electrical stimuli delivered to the atria at fast rates. Alternating Wenckebach periods of St-H and St-delta wave intervals in patients with the Wolff-Parkinson-White syndrome resulted from involvement of the Kent bundle itself, or of the atria as a proximal level common to distal longitudinally dissociated structures (Kent bundle and A-V node).</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">It is concluded that contrary to what is commonly believed alternating Wenckebach periods may be a tachycardia-dependent phenomenon occurring above, below or outside the A-V node and explaining a variety of spontaneous or electrically induced arrhythmias whose significance depends on the clinical setting in which they occur.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Alternating Wenckebach periods occurring in the atria, His-Purkinje system, ventricles and kent bundle</title></titleInfo><name type="personal"><namePart type="given">Agustin</namePart><namePart type="family">Castellanos</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation><description>Address for reprints: Agustin Castellanos, MD, Division of Cardiology, University of Miami School of Medicine, P.O. Box 520875, Miami, Florida 33152.</description><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ruey J.</namePart><namePart type="family">Sung</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Juan L.</namePart><namePart type="family">Aldrich</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Ivan J.</namePart><namePart type="family">Mendoza</namePart><namePart type="termsOfAddress">MD</namePart><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Robert J.</namePart><namePart type="family">Myerburg</namePart><namePart type="termsOfAddress">MD, FACC</namePart><affiliation>From the Division of Cardiology, Department of Medicine, University of Miami School of Medicine Miami, Florida U.S.A.</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">1977</dateIssued><dateValid encoding="w3cdtf">1977-06-22</dateValid><dateModified encoding="w3cdtf">1977-06-22</dateModified><copyrightDate encoding="w3cdtf">1977</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">Alternating Wenckebach periods were defined as episodes of 2:1 block during which there was a gradual prolongation of the transmission intervals preceding the appearance of 3:1 or 4:1 block. Alternating Wenckebach periods occurring within the His-Purkinje system in symptomatic patients with right bundle branch block could have resulted from involvement of the His bundle only, the left bundle branch only or both structures simultaneously. Alternating Wenckebach patterns presumably occurring in the reentry pathway of ventricular extrasystoles and in the tissues surrounding an ectopic atrial focus or bipolar pacing electrodes were manifested in the coupling intervals of the premature beats; in the P-P intervals of atrial tachycardia with atrioventricular (A-V) block due to digitalis; and in the stimulus (St)-A intervals following electrical stimuli delivered to the atria at fast rates. Alternating Wenckebach periods of St-H and St-delta wave intervals in patients with the Wolff-Parkinson-White syndrome resulted from involvement of the Kent bundle itself, or of the atria as a proximal level common to distal longitudinally dissociated structures (Kent bundle and A-V node).It is concluded that contrary to what is commonly believed alternating Wenckebach periods may be a tachycardia-dependent phenomenon occurring above, below or outside the A-V node and explaining a variety of spontaneous or electrically induced arrhythmias whose significance depends on the clinical setting in which they occur.</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">197712</dateIssued></originInfo><identifier type="ISSN">0002-9149</identifier><identifier type="PII">S0002-9149(00)X0508-5</identifier><part><date>197712</date><detail type="volume"><number>40</number><caption>vol.</caption></detail><detail type="issue"><number>6</number><caption>no.</caption></detail><extent unit="issue pages"><start>A3</start><end>A47</end></extent><extent unit="issue pages"><start>A51</start><end>A63</end></extent><extent unit="issue pages"><start>A70</start><end>A72</end></extent><extent unit="issue pages"><start>A81</start><end>A88</end></extent><extent unit="issue pages"><start>A95</start><end>A111</end></extent><extent unit="issue pages"><start>839</start><end>1032</end></extent><extent unit="pages"><start>853</start><end>859</end></extent></part></relatedItem><identifier type="istex">CC56E81D62FBAE82E9766733B159D48B9D8905BC</identifier><identifier type="DOI">10.1016/0002-9149(77)90034-0</identifier><identifier type="PII">0002-9149(77)90034-0</identifier><identifier type="ArticleID">77900340</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/CC56E81D62FBAE82E9766733B159D48B9D8905BC/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><analytic><title level="a" type="main">A-V conduction in auricular flutter</title><author><persName><surname>Besoain</surname></persName></author><author><persName><forename type="middle">M</forename><surname>Santander</surname></persName></author><author><persName><forename type="middle">A</forename><surname>Pick</surname></persName></author><author><persName><surname>Langendorf</surname></persName></author></analytic><monogr><title level="j">Circulation</title><imprint><biblScope unit="volume">2</biblScope><biblScope unit="page" from="604" to="616"></biblScope><date type="published" when="1950"></date></imprint></monogr></biblStruct><biblStruct><monogr><title level="m" type="main">Clinical Electrocardiography. 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