Ventricular Quadrigeminy as a Manifestation of Concealed
نویسندگان
چکیده
Long rhythm strips were analyzed from five patients with frequent ventricular extrasystoles. The predominant pattern was quadrigeminal; i.e., three sinus beats between extrasystoles. However, about 20% of the interectopic intervals contained numbers of sinus beats (S) greater than three. Analysis of the distribution of such values of S > 3 revealed that there were many more odd than even values (P < 0.001). Also, carotid sinus pressure yielded only odd values of S > 3. This predominance of odd values strongly suggested the existence of concealed extrasystoles. Therefore, all odd values of S > 3 were analyzed to determine whether they satisfied the criterion for concealed bigeminy (S = 2n 1) or for concealed quadrigeminy (S = 4n 1). The distribution was found to satisfy the criterion for concealed bigeminy, suggesting that the quadrigeminal pattern was a manifestation of a 2:1 rather than a 4:1 block in a re-entry loop. Stable quadrigeminy occurs often in concealed bigeminy, because the re-entrant impulse finds the myocardium excitable after a normal R-R interval but refractory after a compensatory pause.
منابع مشابه
Ventricular quadrigeminy as a manifestation of concealed bigeminy.
Long rhythm strips were analyzed from five patients with frequent ventricular extrasystoles. The predominant pattern was quadrigeminal; i.e., three sinus beats between extrasystoles. However, about 20% of the interectopic intervals contained numbers of sinus beats (S) greater than three. Analysis of the distribution of such values of S greater than 3 revealed that there were many more odd than ...
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coupling interval, and the "rule of multiples." Saishin-Igaku 15: 1865, 1960 2. Schamroth L, Marriott JHL: Intermittent ventricular parasystole with observations on its relationship to extrasystolic bigeminy. Am J Cardiol 7: 799, 1961 3. Schamroth L, Marriott HJL: Concealed ventricular extrasystoles. Circulation 27: 1043, 1963 4. Schamroth L: The physiological basis of ectopic ventricular rhyth...
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