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Asymptomatic Ventricular Arrhythmias in Healthy Persons: Smoke or Smoke Screen?

Arthur J. Moss, MD
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Request for Reprints: Arthur J. Moss, MD, Heart Research Follow-up Program, Box 653, University of Rochester Medical Center, Rochester, NY 14642.

University of Rochester Medical Center
Rochester, NY 14642

Ann Intern Med. 1992;117(12):1053-1054. doi:10.7326/0003-4819-117-12-1053
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During the past decade, considerable progress has been made in understanding the mechanisms underlying the origin of normal and ectopic beats (1-3). In addition to intrinsic sinus node automaticity, latent automatic foci exist throughout the heart, especially in the atrioventricular node and the ventricular His-Purkinje system, to provide a safety net for back-up intrinsic rhythms should the sinus node fail. These latent pacemakers may accelerate in normal hearts and may appear as ectopic beats and rhythms. The electrical conducting network within the myocardium exhibits complex spatial geometry with a potential for re-entrant conduction (4). In addition, neuroendocrine factors, mediated mostly


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