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Articles

Sinus Node Reentry

An In Vivo Demonstration In The Dog

KARLEN L. PAULAY, P. JACOB VARGHESE, ANTHONY N. DAMATO
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https://doi.org/10.1161/01.RES.32.4.455
Circulation Research. 1973;32:455-463
Originally published April 1, 1973
KARLEN L. PAULAY
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P. JACOB VARGHESE
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ANTHONY N. DAMATO
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Abstract

The phenomenon of sinus node reentry was investigated in 20 dogs by programed atrial stimulation during sinus rhythm and atrial pacing. Recordings were made simultaneously at multiple atrial sites. In 18 dogs, a closely coupled premature atrial beat (A2) introduced into the region of the coronary sinus, the right or the left atrial appendage, or the Bachmann bundle was followed 100-300 msec later by an accelerated beat (A3) consistent with sinus node reentry. The atrial activation sequence and the P-wave morphology of A3 and of the spontaneous sinus beats were similar. The occurrence of A3 during sinus rhythm and atrial pacing was dependent on the coupling interval of A2 and the arrival time of excitation in the region of the sinus node but was independent of the atrial site at which A2 was introduced; A3 could be clearly distinguished from local or atrioventricular node reentry and sinus node entrance block. Moreover, crushing of the sinus node (10 dogs) or vagal stimulation (7 dogs) prevented the appearance of A3 in all dogs, presumably by blocking the sinus node reentry pathway. During graded vagal stimulation a progressive increase in the A2-A3 interval occurred. Sinus node reentry was sustained for three cycles in 1 dog. Sinus node reentry may be one mechanism for interpolated atrial premature depolarization and some atrial tachyarrhythmias seen clinically.

  • atrial pacing
  • atrial premature depolarization
  • atrial reentry
  • atrial
  • fibrillation
  • atrial arrhythmia
  • sinus node entrance block
  • vagal stimulation
  • crushing of sinus node
  • Received September 11, 1972.
  • Accepted January 29, 1973.
  • © 1973 American Heart Association, Inc.
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Circulation Research
April 1, 1973, Volume 32, Issue 4
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    Sinus Node Reentry
    KARLEN L. PAULAY, P. JACOB VARGHESE and ANTHONY N. DAMATO
    Circulation Research. 1973;32:455-463, originally published April 1, 1973
    https://doi.org/10.1161/01.RES.32.4.455

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    Sinus Node Reentry
    KARLEN L. PAULAY, P. JACOB VARGHESE and ANTHONY N. DAMATO
    Circulation Research. 1973;32:455-463, originally published April 1, 1973
    https://doi.org/10.1161/01.RES.32.4.455
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