Key result
Linking phenomenon maintains persistent aberrancy in AVNRT via delayed retrograde concealed activation.
Case Report (n=2)
This case series demonstrates that the 'linking' phenomenon can maintain aberrant intraventricular conduction during AVNRT.
We present 2 cases of the slow-fast form of AVNRT with initially narrow QRS complexes followed by sudden unexpected transition to persistently wide QRS complexes due to aberrant intraventricular conduction. Introduction of a properly timed extrastimulus in one case and critical oscillations in cycle length due to short-long coupling in the second case set the stage for the initial bundle branch block. However, persistence of the aberrancy pattern once the initial event abated was maintained by the "linking" phenomenon. Delayed, retrograde concealed activation from the contralateral bundle branch perpetuated the initial bundle branch block.
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Caldwell et al. (2013) conducted a case report in AVNRT with aberrant intraventricular conduction (n=2). Linking phenomenon was evaluated on Aberrant intraventricular conduction. In two cases of AVNRT, the persistence of an aberrancy pattern after an initial bundle branch block was maintained by the linking phenomenon via delayed, retrograde concealed activation.
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