Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node
Identifieur interne : 000A98 ( Main/Corpus ); précédent : 000A97; suivant : 000A99Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node
Auteurs : Otto L. Garcia ; Agustin Castellanos ; Ruey J. Sung ; Henry GelbandSource :
- American Heart Journal [ 0002-8703 ] ; 1977.
Abstract
In two infants with Wolff-Parkinson-White type B, right bundle branch block was concealed during sinus rhythm and pacing from close to the atrial entrance of the right-sided accessory pathway. However, pacing from the vicinity of the A-V node, the A-V node itself, and the His bundle exposed the right bundle branch block by producing exclusive ventricular activation through the normal, A-V nodal His-Purkinje pathway.In addition, pacing from close to the A-V node also resulted in fusion beats characterized by absence of delta waves with (pseudo) normal QRS complexes and short H-V intervals. False patterns of tachycardia-dependent and bradycardia-dependent block in the accessory pathway also occurred. These dynamic phenomena were attributed to the (peri-A-V nodal) pacing-related, relatively early arrival of excitation at the ventricles through the normal pathways coexisting with delayed arrival of excitation via the accessory pathway. The latter in turn was due to the longer intra-atrial conduction time from paced (peri-A-V nodal) site to atrial entrance of the accessory pathway.
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DOI: 10.1016/0002-8703(78)90204-1
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Garcia</name><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author><author><name sortKey="Castellanos, Agustin" sort="Castellanos, Agustin" uniqKey="Castellanos A" first="Agustin" last="Castellanos">Agustin Castellanos</name><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author><author><name sortKey="Sung, Ruey J" sort="Sung, Ruey J" uniqKey="Sung R" first="Ruey J." last="Sung">Ruey J. Sung</name><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author><author><name sortKey="Gelband, Henry" sort="Gelband, Henry" uniqKey="Gelband H" first="Henry" last="Gelband">Henry Gelband</name><affiliation><mods:affiliation>Reprint requests: Henry Gelband, M.D., Pediatric Cardiology, Dept. of Pediatrics, University of Miami, School of Medicine, P.O. Box 016820, Miami, Fla. 33101.</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:B234F951C8A1504D59B59324C2BCA9218523B941</idno><date when="1978" year="1978">1978</date><idno type="doi">10.1016/0002-8703(78)90204-1</idno><idno type="url">https://api.istex.fr/document/B234F951C8A1504D59B59324C2BCA9218523B941/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">000A98</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a" type="main" xml:lang="en">Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node</title><author><name sortKey="Garcia, Otto L" sort="Garcia, Otto L" uniqKey="Garcia O" first="Otto L." last="Garcia">Otto L. Garcia</name><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author><author><name sortKey="Castellanos, Agustin" sort="Castellanos, Agustin" uniqKey="Castellanos A" first="Agustin" last="Castellanos">Agustin Castellanos</name><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author><author><name sortKey="Sung, Ruey J" sort="Sung, Ruey J" uniqKey="Sung R" first="Ruey J." last="Sung">Ruey J. Sung</name><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author><author><name sortKey="Gelband, Henry" sort="Gelband, Henry" uniqKey="Gelband H" first="Henry" last="Gelband">Henry Gelband</name><affiliation><mods:affiliation>Reprint requests: Henry Gelband, M.D., Pediatric Cardiology, Dept. of Pediatrics, University of Miami, School of Medicine, P.O. Box 016820, Miami, Fla. 33101.</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation><affiliation><mods:affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</mods:affiliation></affiliation></author></analytic><monogr></monogr><series><title level="j">American Heart Journal</title><title level="j" type="abbrev">YMHJ</title><idno type="ISSN">0002-8703</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977">1977</date><biblScope unit="volume">96</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="662">662</biblScope><biblScope unit="page" to="668">668</biblScope></imprint><idno type="ISSN">0002-8703</idno></series><idno type="istex">B234F951C8A1504D59B59324C2BCA9218523B941</idno><idno type="DOI">10.1016/0002-8703(78)90204-1</idno><idno type="PII">0002-8703(78)90204-1</idno><idno type="ArticleID">78902041</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">0002-8703</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract" xml:lang="en">In two infants with Wolff-Parkinson-White type B, right bundle branch block was concealed during sinus rhythm and pacing from close to the atrial entrance of the right-sided accessory pathway. However, pacing from the vicinity of the A-V node, the A-V node itself, and the His bundle exposed the right bundle branch block by producing exclusive ventricular activation through the normal, A-V nodal His-Purkinje pathway.In addition, pacing from close to the A-V node also resulted in fusion beats characterized by absence of delta waves with (pseudo) normal QRS complexes and short H-V intervals. False patterns of tachycardia-dependent and bradycardia-dependent block in the accessory pathway also occurred. These dynamic phenomena were attributed to the (peri-A-V nodal) pacing-related, relatively early arrival of excitation at the ventricles through the normal pathways coexisting with delayed arrival of excitation via the accessory pathway. The latter in turn was due to the longer intra-atrial conduction time from paced (peri-A-V nodal) site to atrial entrance of the accessory pathway.</div></front></TEI><istex><corpusName>elsevier</corpusName><author><json:item><name>Otto L. Garcia M.D.</name><affiliations><json:string>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string><json:string>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string></affiliations></json:item><json:item><name>Agustin Castellanos M.D.</name><affiliations><json:string>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string><json:string>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string></affiliations></json:item><json:item><name>Ruey J. Sung M.D.</name><affiliations><json:string>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string><json:string>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string></affiliations></json:item><json:item><name>Henry Gelband M.D.</name><affiliations><json:string>Reprint requests: Henry Gelband, M.D., Pediatric Cardiology, Dept. of Pediatrics, University of Miami, School of Medicine, P.O. Box 016820, Miami, Fla. 33101.</json:string><json:string>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string><json:string>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</json:string></affiliations></json:item></author><articleId><json:string>78902041</json:string></articleId><language><json:string>eng</json:string></language><abstract>In two infants with Wolff-Parkinson-White type B, right bundle branch block was concealed during sinus rhythm and pacing from close to the atrial entrance of the right-sided accessory pathway. However, pacing from the vicinity of the A-V node, the A-V node itself, and the His bundle exposed the right bundle branch block by producing exclusive ventricular activation through the normal, A-V nodal His-Purkinje pathway.In addition, pacing from close to the A-V node also resulted in fusion beats characterized by absence of delta waves with (pseudo) normal QRS complexes and short H-V intervals. False patterns of tachycardia-dependent and bradycardia-dependent block in the accessory pathway also occurred. These dynamic phenomena were attributed to the (peri-A-V nodal) pacing-related, relatively early arrival of excitation at the ventricles through the normal pathways coexisting with delayed arrival of excitation via the accessory pathway. The latter in turn was due to the longer intra-atrial conduction time from paced (peri-A-V nodal) site to atrial entrance of the accessory pathway.</abstract><qualityIndicators><score>4.504</score><pdfVersion>1.3</pdfVersion><pdfPageSize>591 x 806 pts</pdfPageSize><refBibsNative>true</refBibsNative><keywordCount>0</keywordCount><abstractCharCount>1093</abstractCharCount><pdfWordCount>2572</pdfWordCount><pdfCharCount>19438</pdfCharCount><pdfPageCount>7</pdfPageCount><abstractWordCount>161</abstractWordCount></qualityIndicators><title>Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node</title><pii><json:string>0002-8703(78)90204-1</json:string></pii><genre><json:string>research-article</json:string></genre><host><volume>96</volume><pii><json:string>S0002-8703(00)X0074-9</json:string></pii><pages><last>668</last><first>662</first></pages><issn><json:string>0002-8703</json:string></issn><issue>5</issue><genre><json:string>Journal</json:string></genre><language><json:string>unknown</json:string></language><title>American Heart Journal</title><publicationDate>1978</publicationDate></host><publicationDate>1977</publicationDate><copyrightDate>1978</copyrightDate><doi><json:string>10.1016/0002-8703(78)90204-1</json:string></doi><id>B234F951C8A1504D59B59324C2BCA9218523B941</id><fulltext><json:item><original>true</original><mimetype>application/pdf</mimetype><extension>pdf</extension><uri>https://api.istex.fr/document/B234F951C8A1504D59B59324C2BCA9218523B941/fulltext/pdf</uri></json:item><json:item><original>true</original><mimetype>text/plain</mimetype><extension>txt</extension><uri>https://api.istex.fr/document/B234F951C8A1504D59B59324C2BCA9218523B941/fulltext/txt</uri></json:item><json:item><original>false</original><mimetype>application/zip</mimetype><extension>zip</extension><uri>https://api.istex.fr/document/B234F951C8A1504D59B59324C2BCA9218523B941/fulltext/zip</uri></json:item><istex:fulltextTEI uri="https://api.istex.fr/document/B234F951C8A1504D59B59324C2BCA9218523B941/fulltext/tei"><teiHeader><fileDesc><titleStmt><title level="a" type="main" xml:lang="en">Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node</title></titleStmt><publicationStmt><authority>ISTEX</authority><publisher>ELSEVIER</publisher><availability><p>ELSEVIER</p></availability><date>1978</date></publicationStmt><notesStmt><note type="content">Section title: Case report</note></notesStmt><sourceDesc><biblStruct type="inbook"><analytic><title level="a" type="main" xml:lang="en">Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node</title><author><persName><forename type="first">Otto L.</forename><surname>Garcia</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation></author><author><persName><forename type="first">Agustin</forename><surname>Castellanos</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation></author><author><persName><forename type="first">Ruey J.</forename><surname>Sung</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation></author><author><persName><forename type="first">Henry</forename><surname>Gelband</surname></persName><roleName type="degree">M.D.</roleName><affiliation>Reprint requests: Henry Gelband, M.D., Pediatric Cardiology, Dept. of Pediatrics, University of Miami, School of Medicine, P.O. Box 016820, Miami, Fla. 33101.</affiliation><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation></author></analytic><monogr><title level="j">American Heart Journal</title><title level="j" type="abbrev">YMHJ</title><idno type="pISSN">0002-8703</idno><idno type="PII">S0002-8703(00)X0074-9</idno><imprint><publisher>ELSEVIER</publisher><date type="published" when="1977"></date><biblScope unit="volume">96</biblScope><biblScope unit="issue">5</biblScope><biblScope unit="page" from="662">662</biblScope><biblScope unit="page" to="668">668</biblScope></imprint></monogr><idno type="istex">B234F951C8A1504D59B59324C2BCA9218523B941</idno><idno type="DOI">10.1016/0002-8703(78)90204-1</idno><idno type="PII">0002-8703(78)90204-1</idno><idno type="ArticleID">78902041</idno></biblStruct></sourceDesc></fileDesc><profileDesc><creation><date>1978</date></creation><langUsage><language ident="en">en</language></langUsage><abstract xml:lang="en"><p>In two infants with Wolff-Parkinson-White type B, right bundle branch block was concealed during sinus rhythm and pacing from close to the atrial entrance of the right-sided accessory pathway. However, pacing from the vicinity of the A-V node, the A-V node itself, and the His bundle exposed the right bundle branch block by producing exclusive ventricular activation through the normal, A-V nodal His-Purkinje pathway.In addition, pacing from close to the A-V node also resulted in fusion beats characterized by absence of delta waves with (pseudo) normal QRS complexes and short H-V intervals. False patterns of tachycardia-dependent and bradycardia-dependent block in the accessory pathway also occurred. These dynamic phenomena were attributed to the (peri-A-V nodal) pacing-related, relatively early arrival of excitation at the ventricles through the normal pathways coexisting with delayed arrival of excitation via the accessory pathway. The latter in turn was due to the longer intra-atrial conduction time from paced (peri-A-V nodal) site to atrial entrance of the accessory pathway.</p></abstract></profileDesc><revisionDesc><change when="1977-11-18">Registration</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>YMHJ</jid><aid>78902041</aid><ce:pii>0002-8703(78)90204-1</ce:pii><ce:doi>10.1016/0002-8703(78)90204-1</ce:doi><ce:copyright type="unknown" year="1978"></ce:copyright></item-info><head><ce:dochead><ce:textfn>Case report</ce:textfn></ce:dochead><ce:title>Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node</ce:title><ce:author-group><ce:author><ce:given-name>Otto L.</ce:given-name><ce:surname>Garcia</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Agustin</ce:given-name><ce:surname>Castellanos</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Ruey J.</ce:given-name><ce:surname>Sung</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:author><ce:given-name>Henry</ce:given-name><ce:surname>Gelband</ce:surname><ce:degrees>M.D.</ce:degrees><ce:cross-ref refid="COR1"><ce:sup loc="post">1</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF1"><ce:sup loc="post">a</ce:sup></ce:cross-ref><ce:cross-ref refid="AFF2"><ce:sup loc="post">b</ce:sup></ce:cross-ref></ce:author><ce:affiliation id="AFF1"><ce:label>a</ce:label><ce:textfn>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</ce:textfn></ce:affiliation><ce:affiliation id="AFF2"><ce:label>b</ce:label><ce:textfn>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</ce:textfn></ce:affiliation><ce:correspondence id="COR1"><ce:label>1</ce:label><ce:text>Reprint requests: Henry Gelband, M.D., Pediatric Cardiology, Dept. of Pediatrics, University of Miami, School of Medicine, P.O. Box 016820, Miami, Fla. 33101.</ce:text></ce:correspondence></ce:author-group><ce:date-received day="10" month="10" year="1977"></ce:date-received><ce:date-accepted day="18" month="11" 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">In two infants with Wolff-Parkinson-White type B, right bundle branch block was concealed during sinus rhythm and pacing from close to the atrial entrance of the right-sided accessory pathway. However, pacing from the vicinity of the A-V node, the A-V node itself, and the His bundle exposed the right bundle branch block by producing exclusive ventricular activation through the normal, A-V nodal His-Purkinje pathway.</ce:simple-para><ce:simple-para view="all" id="simple-para.0015">In addition, pacing from close to the A-V node also resulted in fusion beats characterized by absence of delta waves with (pseudo) normal QRS complexes and short H-V intervals. False patterns of tachycardia-dependent and bradycardia-dependent block in the accessory pathway also occurred. These dynamic phenomena were attributed to the (peri-A-V nodal) pacing-related, relatively early arrival of excitation at the ventricles through the normal pathways coexisting with delayed arrival of excitation via the accessory pathway. The latter in turn was due to the longer intra-atrial conduction time from paced (peri-A-V nodal) site to atrial entrance of the accessory pathway.</ce:simple-para></ce:abstract-sec></ce:abstract></head></converted-article></istex:document></istex:metadataXml><mods version="3.6"><titleInfo lang="en"><title>Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node</title></titleInfo><titleInfo type="alternative" lang="en" contentType="CDATA"><title>Exposure of concealed right bundle branch block in Wolff-Parkinson-White type B by pacing from the vicinity of the A-V node</title></titleInfo><name type="personal"><namePart type="given">Otto L.</namePart><namePart type="family">Garcia</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Agustin</namePart><namePart type="family">Castellanos</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><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">M.D.</namePart><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><role><roleTerm type="text">author</roleTerm></role></name><name type="personal"><namePart type="given">Henry</namePart><namePart type="family">Gelband</namePart><namePart type="termsOfAddress">M.D.</namePart><affiliation>Reprint requests: Henry Gelband, M.D., Pediatric Cardiology, Dept. of Pediatrics, University of Miami, School of Medicine, P.O. Box 016820, Miami, Fla. 33101.</affiliation><affiliation>Division of Pediatric, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., USA</affiliation><affiliation>Division of Adult Cardiology, Department of Pediatrics and Medicine, University of Miami School of Medicine, Miami, Fla., 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">1977</dateIssued><dateValid encoding="w3cdtf">1977-11-18</dateValid><copyrightDate encoding="w3cdtf">1978</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">In two infants with Wolff-Parkinson-White type B, right bundle branch block was concealed during sinus rhythm and pacing from close to the atrial entrance of the right-sided accessory pathway. However, pacing from the vicinity of the A-V node, the A-V node itself, and the His bundle exposed the right bundle branch block by producing exclusive ventricular activation through the normal, A-V nodal His-Purkinje pathway.In addition, pacing from close to the A-V node also resulted in fusion beats characterized by absence of delta waves with (pseudo) normal QRS complexes and short H-V intervals. False patterns of tachycardia-dependent and bradycardia-dependent block in the accessory pathway also occurred. These dynamic phenomena were attributed to the (peri-A-V nodal) pacing-related, relatively early arrival of excitation at the ventricles through the normal pathways coexisting with delayed arrival of excitation via the accessory pathway. The latter in turn was due to the longer intra-atrial conduction time from paced (peri-A-V nodal) site to atrial entrance of the accessory pathway.</abstract><note type="content">Section title: Case report</note><relatedItem type="host"><titleInfo><title>American Heart Journal</title></titleInfo><titleInfo type="abbreviated"><title>YMHJ</title></titleInfo><genre type="Journal">journal</genre><originInfo><dateIssued encoding="w3cdtf">197811</dateIssued></originInfo><identifier type="ISSN">0002-8703</identifier><identifier type="PII">S0002-8703(00)X0074-9</identifier><part><date>197811</date><detail type="volume"><number>96</number><caption>vol.</caption></detail><detail type="issue"><number>5</number><caption>no.</caption></detail><extent unit="issue pages"><start>A1</start><end>A26</end></extent><extent unit="issue pages"><start>A55</start><end>A62</end></extent><extent unit="issue pages"><start>569</start><end>708</end></extent><extent unit="pages"><start>662</start><end>668</end></extent></part></relatedItem><identifier type="istex">B234F951C8A1504D59B59324C2BCA9218523B941</identifier><identifier type="DOI">10.1016/0002-8703(78)90204-1</identifier><identifier type="PII">0002-8703(78)90204-1</identifier><identifier type="ArticleID">78902041</identifier><recordInfo><recordContentSource>ELSEVIER</recordContentSource></recordInfo></mods></metadata><enrichments><istex:refBibTEI uri="https://api.istex.fr/document/B234F951C8A1504D59B59324C2BCA9218523B941/enrichments/refBib"><teiHeader></teiHeader><text><front></front><body></body><back><listBibl><biblStruct><monogr></monogr></biblStruct></listBibl></back></text></istex:refBibTEI></enrichments><serie></serie></istex></record>Pour manipuler ce document sous Unix (Dilib)
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