|
KMID : 1011920100110020052
|
|
International Journal of Arrhythmia
2010 Volume.11 No. 2 p.52 ~ p.56
|
|
|
A case of atrioventricular dissociation with interference
|
|
Sung Jung-Hoon
|
|
|
Abstract
|
|
|
|
Interference dissociation is one of the most interesting arrhythmias. Once thought to be a rare arrhythmia, it is now considered a very common one. A 69-year-old female patient presented to our hospital with a chief complaint of dizziness and dyspnea on exertion that worsened since a month ago. On electrocardiogram, marked bradycardia (VR [ventricular rhythm] = 42 beat/min) was noted. P waves, without QRS correlation were seen, and the QRS complex was narrow. As the same rhythm was detected on 24-hour Holter monitoring with the patient experiencing dizziness, stress testing was performed upon which chronotropic incompetence was found. During an electrophysiology study, the abnormal finding of sinus node recovery time (RAP 500 ms) of 4,964 ms was noted. Therefore, a pacemaker of AAI type was inserted. Interference dissociation is defined as one of the dissociations caused by repetitive contradirectional interference, which leads to A-V dissociation. In general, as the ventricular rhythm is faster than the atrial rhythm, the P wave is seen progressively closer to the QRS complex, then disappears altogether, When passing through the QRS complex, to re-appear after the QRS complex. The P wave passing through the QRS complex is seen as ventricular capture, atrial capture, synchronization, or accrochage.
|
|
|
KEYWORD
|
|
|
interference dissociation, ventricular capture, chronotropic incompetence
|
|
|
FullTexts / Linksout information
|
|
|
|
|
Listed journal information
|
|
|
|
|