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Electrophysiological study of reciprocating tachycardia utilizing retrograde accessory pathways especially about the effectiveness and mechanism of action of verapamil and disopyramide






Medical Journal of Kobe University 45(1): 91-104

Electrophysiological study of reciprocating tachycardia utilizing retrograde accessory pathways especially about the effectiveness and mechanism of action of verapamil and disopyramide

The effectiveness and mechanism of action were electrophysiologically studied after 10 mg of i.v. verapamil (V) and 100 mg of i.v. disopyramide (D) on reciprocating tachycardia (RT) utilizing retrograde accessory pathway (AP) in 27 patients including 23 cases of Wolff-Parkinson-White syndrome (WPW), 2 cases of concealed WPW and 1 case of concealed atrio-His bypass. Conduction properties were evaluated before and after each drug using incremental atrial pacing; atrial extrastimulus testing; incremental ventricular pacing and ventriclar extrastimulus testing. V revealed a remarkable effect in delaying conduction and prolonging refractoriness in the atrioventricular node (AVN), while D had a variable effect in the AVN. D produced complete antegrade block in the AP in 7 of 12 cases with WPW syndrome. Although antegrade effective refractory period of AP (APPAERP) was not significantly prolonged in the other 5 cases, AP conduction was suppressed after D by the incremental atrial pacing. V could terminate the induced RT in all 7 cases, but D could neither terminate the induced RT nor decrease the cardiac rate remarkably in all 4 cases including 1 case of WPW, 2 cases of concealed WPW and 1 case of concealed atrio-His bypass. V was effective in terminating sustained RT in the majority of patients with WPW syndrome because of an increase in AV nodal refractoriness, but D was not always effective in these cases.


Accession: 005349842



Related references

Kan Z.; Inoue T.; Yamabe H.; Tajiri E.; Toda T.; Fujitani K.; Kobayashi K.; Fukuzaki H., 1981: Electro physiological studies of the effects of disopyramide phosphate on reciprocating tachy cardia utilizing retrograde accessory pathway. Japanese Circulation Journal 45(8): 912

Tonkin, A.M.; Gallagher, J.J.; Svenson, R.H.; Wallace, A.G.; Sealy, W.C., 1975: Anterograde block in accessory pathways with retrograde conduction in reciprocating tachycardia. 3 patients with reciprocating tachycardia are described. In all 3, tachycardia was due to a reentrant mechanism. Anterograde conduction was via the AV node while retrograde conduction was over an accessory (Kent) pathway. In none of the 3 patients...

Kay, G.N.; Pressley, J.C.; Packer, D.L.; Pritchett, E.L.; German, L.D.; Gilbert, M.R., 1987: Value of the 12-lead electrocardiogram in discriminating atrioventricular nodal reciprocating tachycardia from circus movement atrioventricular tachycardia utilizing a retrograde accessory pathway. The value of the 12-lead electrocardiogram for distinguishing atrioventricular (AV) nodal reciprocating tachycardia from circus movement AV tachycardia utilizing a retrograde accessory pathway was studied in 100 patients with narrow QRS complex ta...

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Garcia Civera, R.; Ferrero, J.A.; Sanjuan, R.; Insa, L.; Rodriguez, M.; Segui, J.; Lopez Merino, V.; Llavador, J., 1980: Retrograde P wave polarity in reciprocating tachycardia utilizing lateral bypass tracts. European Heart Journal 1(2): 137-145

Ross, D.L.; Wiener, I.; Farre, J.; Bar, F.W.; Vanagt, E.J.; Wellens, H.J., 1981: Termination of circus movement tachycardia utilizing an accessory atrioventricular pathway by retrograde concealed penetration of the atrioventricular node through the bundle branch system. A mechanism of tachycardia termination in Wolff-Parkinson-White syndrome. A 30 year old woman with Wolff-Parkinson-White syndrome underwent electrophysiologic study for investigation of circus movement tachycardia utilizing the accessory pathway for retrograde conduction. The accessory pathway was located on the right s...