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Supernormal conduction is defined as conduction more rapid than expected or present when block is anticipated, often simulated by phenomena like dual AV nodal conduction or the gap phenomenon.
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Clarifies the mechanisms and appropriate terminology for 'supernormal' conduction in electrocardiography, distinguishing true supernormality from simulating phenomena.
Electrocardiographic manifestation of "supernormal" conduction is defined as conduction that is more rapid than expected or presence of conduction when block is anticipated. It is not supernormal in the sense or being more rapid than normal. Therefore, the term relative supernormality or "supernormality" is more appropriate. The mechanism of "supernormal" conduction is conduction during a period of supernormal excitability and conduction associated with altered membrane potential. Some of the more common phenomena that are not dependent on conduction during the supernormal period but manifest better than expected conduction, thus simulating "supernormal" conduction, include dual AV nodal conduction, the "gap" phenomenon, "peeling back" of the refractory period, summation of subthreshold responses, diastolic phase 4 depolarization, and phasic autonomic influences.
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Spear et al. (1993) conducted a review in Supernormal conduction. Supernormal conduction is defined as conduction more rapid than expected or present when block is anticipated, often simulated by phenomena like dual AV nodal conduction or the gap phenomenon.
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