What question did this study set out to answer?

To assess how different atrial pacing sites affect A-H interval conduction dynamics and tissue refractoriness in patients with short P-R intervals and supraventricular tachyarrhythmias.

January 1, 1976CirculationOpen Access

Effects of the pacing site on A-H conduction and refractoriness in patients with short P-R intervals.

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Why the study?

Does the pacing site influence A-H conduction and refractoriness in patients with short P-R intervals and supraventricular tachyarrhythmias?

Population

4 patients with short P-R and A-H intervals, narrow QRS complexes, and a history of supraventricular…

Comparison

Pacing from the coronary sinus, low right… vs Pacing from the high right atrium (HRA)

Design

Case_series

Authors

JAJuan ArandaUniversidad Complutense de Madrid ACA CastellanosUniversity of Miami Hospital FMF MoleiroCentral University of Venezuela

Discussion

Member takes

Implication

Pacing site may influence A-H conduction in short-PR patients; hypothesis-generating and should not yet change practice.

Key Points

To assess how different atrial pacing sites affect A-H interval conduction dynamics and tissue refractoriness in patients with short P-R intervals and supraventricular tachyarrhythmias.
Recorded His bundle electrograms in 4 patients exhibiting short P-R intervals, short A-H intervals, and narrow QRS complexes with histories of supraventricular tachyarrhythmias.
Delivered atrial pacing and programmed extrastimuli at multiple intracardiac sites, including the high right atrium (HRA), coronary sinus (CS), low right atrium (LRA), and mid-right atrium (MRA).
Coronary sinus pacing produced smaller A-H interval increases and sustained 1:1 conduction up to higher Wenckebach pacing rates (>200 beats/min) than high right atrial pacing in 3 patients.
Functional refractory period of the A-H tissues was 15 to 25 msec shorter during coronary sinus pacing than during high right atrial pacing in two tested patients.
Varying the pacing location revealed distinct conduction gap phenomena (type 1 from HRA, type 2 from CS) and differential access to dual AV pathways.

Structured PICO

Does the pacing site influence A-H conduction and refractoriness in patients with short P-R intervals and supraventricular tachyarrhythmias?

Population

4 patients with short P-R and A-H intervals, narrow QRS complexes, and a history of supraventricular tachyarrhythmias

Intervention

Pacing from the coronary sinus (CS), low right atrium (LRA), or mid-right atrium (MRA)

Comparator

Pacing from the high right atrium (HRA)

Outcome

A-H conduction pattern and refractoriness (including A-H Wenckebach phenomenon, A-H interval increments, and functional refractory period)surrogate

The pacing site significantly influences A-H conduction patterns and refractoriness in patients with short P-R intervals, likely by altering the entry site into the responsible pathways.

Cite This Study

Aranda et al. (1976) studied this question.

synapsesocial.com/papers/6a7ddb790380f7c7805ca526 https://doi.org/10.1161/01.cir.53.1.33

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Effects of the pacing site on A-H conduction and refractoriness in patients with short P-R intervals.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Effects of the pacing site on A-H conduction and refractoriness in patients with short P-R intervals.

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Also Consider