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Simulation of Ectopic Ventricular Rhythms by Aberrant Conduction FREE

Henry J. L. Marriott, MD
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From the Rogers Heart Foundation, St. Petersburg, Fla.


JAMA. 1966;196(9):787-787. doi:10.1001/jama.1966.03100220079026
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The electrocardiogram is indispensable for unravelling complex arrhythmias. Yet the tracing can lead the uninformed astray in the presence of the simplest disturbances of rhythm. Aberrant ventricular conduction is a common occurrence and it is the basis for much arrhythmic confusion. What looks ventricular in origin is not necessarily so; and although the philosophy "Why diagnose when you can convert?" is spreading in this age of electric miracles, more thoughtful therapists still know that there are practical as well as intellectual advantages in knowing what tachyrhythm confronts them.

When a descending impulse reaches the ventricular conducting system and finds part of it blocked or refractory, the impulse is forced to travel by a devious route and writes an anomalous QRS complex. If this state of affairs is more or less permanent and the QRS-T pattern is characteristic, we call the disturbance "bundle-branch block." If, however, the alteration in the QRS

REFERENCES

Gouaux, J.L., and Ashman, R.:  Auricular Fibrillation With Aberration Simulating Ventricular Paroxysmal Tachycardia , Amer Heart J 34:366, 1947;.
Sandler, I.A., and Marriott, H.J.L.:  The Differential Morphology of Anomalous Ventricular Complexes of RBBB-Type in lead V1 , Circulation 31:551, 1965;.
Langendorf, R.; Pick, A.; and Winternitz, M.:  Mechanisms of Intermittent Ventricular Bigeminy: I. Appearance of Ectopic Beats Dependent Upon Length of the Ventricular Cycle, the "Rule of Bigeminy," Circulation 11:422,1955;.

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Gouaux, J.L., and Ashman, R.:  Auricular Fibrillation With Aberration Simulating Ventricular Paroxysmal Tachycardia , Amer Heart J 34:366, 1947;.
Sandler, I.A., and Marriott, H.J.L.:  The Differential Morphology of Anomalous Ventricular Complexes of RBBB-Type in lead V1 , Circulation 31:551, 1965;.
Langendorf, R.; Pick, A.; and Winternitz, M.:  Mechanisms of Intermittent Ventricular Bigeminy: I. Appearance of Ectopic Beats Dependent Upon Length of the Ventricular Cycle, the "Rule of Bigeminy," Circulation 11:422,1955;.
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