BRUCE N. GOLDREYER, M.D.; J. THOMAS BIGGER JR., M.D.
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A 53-year-old man had a regular supraventricular tachycardia that lasted 16 days. Intracavitary electrograms taken during this arrhythmia demonstrated simultaneous atrial and ventricular depolarization. After cardioversion, a study of the relationship between premature atrial and ventricular extrasystoles and the genesis of this arrhythmia was undertaken. An appropriately timed atrial extrasystole produced by an electrical stimulus was twice demonstrated to begin a tachycardia with characteristics identical to his spontaneous arrhythmia. The most likely mechanism for this arrhythmia was atrial reentry via the atrioventricular (AV) junction. Treatment with quinidine resulted in markedly prolonged AV conduction time and refractory periods. After these alterations had been induced by quinidine, this arrhythmia could not be reproduced with stimulated atrial premature systoles identical to those that had previously done so.
GOLDREYER BN, BIGGER JT. Spontaneous and Induced Reentrant Tachycardia. Ann Intern Med. ;70:87–98. doi: 10.7326/0003-4819-70-1-87
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Published: Ann Intern Med. 1969;70(1):87-98.
Cardiology, Rhythm Disorders and Devices.
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