PubMed Health⌕ Search
Home/Archive/PubMed

PubMed · 6233575

[Accessory heart conduction pathways].

C Brechenmacher
View original source ↗Export metadata ↓

Abstract

For several decades, the existence in some hearts of accessory conduction pathways other than the principal pathway (AV node and His bundle) has been postulated. With the development of clinical electrophysiology it seemed important to try and correlate anatomical findings with electrophysiological anomalies. The results of 10 years of research in this direction are summarized here. Ten patients, most of whom died of cardiac arrhythmia, previously had intracavitary electrophysiological studies. The anatomical study required approximately 15.000 histological sections for each of the 10 hearts. During these 10 years we gradually became convinced of the existence of 3 accessory pathways, viz. Kent bundles, atrio-His bundle tracts and Mahaim fibres. In addition, correlations between the anatomical hypotheses inferred from electrophysiology and the results of this anatomical study proved excellent in most cases.

Explore related subjects

Arrhythmias, CardiacAtrioventricular NodeBundle of HisElectrophysiologyHeart Conduction SystemHumansWolff-Parkinson-White SyndromeEnglish AbstractJournal Article

Keep this discovery

Explore connections, maps & timelines

BibTeXRIS

C Brechenmacher. 1984-05-26. [Accessory heart conduction pathways].. https://pubmed.ncbi.nlm.nih.gov/6233575/

Cite the original work for its findings. Save a collection to share your selection of sources.

KEEP EXPLORING

Related citations

PubMed1992

Analysis of vagally induced sinus arrhythmias.

Vagal stimulation at precise times in successive cardiac cycles can elicit sinus arrhythmias. Two mechanisms have been identified that can, but do not necessarily, cause these vagally induced sinus arrhythmias. First, changes in cycle length elicited by a given concentration of acetylcholine (ACh) depend on the phase of the pacemaker cell action potential when the ACh binds to muscarinic receptors. Second, acetylcholinesterase degrades ACh rapidly enough for the mean concentration of ACh per cardiac cycle to vary from cycle to cycle. We used a mathematical model of the underlying cellular physiology, to examine whether these mechanisms are responsible for arrhythmogenesis. Computer simulation showed that both mechanisms contribute to the vagally induced sinus arrhythmias.

Arrhythmias, Cardiac↗
PubMed1992

Prognosis of patients with sustained ventricular tachycardia and of survivors of cardiac arrest not inducible by programmed stimulation.

The aim of this study was to analyze the long-term clinical outcome of 60 prospectively studied patients with documented sustained ventricular tachyarrhythmia that was not inducible during baseline programmed ventricular stimulation: 39 with cardiac arrest due to noninfarction ventricular fibrillation (VF) and 21 with mild hemodynamically compromising sustained ventricular tachycardia (VT). Left ventricular ejection fraction was 55 +/- 14% in the VF group and 50 +/- 13% in the VT group (difference not significant). Patients were discharged without conventional antiarrhythmic drugs and received only empirical beta-blocker therapy. During a mean follow-up period of 21 +/- 16 months (mean +/- SD), 10 of 60 patients (17%) died suddenly. The actuarial incidence of sudden death at 1 and 4 years was similar in both groups (VF group, 10 and 20%; VT group, 16 and 16%) (p = 0.48). The actuarial incidence of sudden cardiac death was significantly higher in patients with left ventricular ejection fraction < or = 40% than in those with > 40% (1-year incidence in VF group, 40 vs 0%; VT group, 50 vs 0%) (p = 0.005 and p = 0.01, respectively). Multivariate regression analysis identified left ventricular ejection fraction < or = 40% and previous myocardial infarction as the only independent predictor of sudden cardiac death. The occurrence of frequent ventricular pairs during Holter monitoring was the only independent predictor of sustained VT recurrences. It is concluded that patients with sustained ventricular tachyarrhythmia in whom arrhythmia was non-inducible during baseline ventricular stimulation and not treated with antiarrhythmic therapy have a favorable outcome if left ventricular ejection fraction is high.(ABSTRACT TRUNCATED AT 250 WORDS)

Arrhythmias, Cardiac↗