A study of atrioventricular conduction in man using premature atrial stimulation and His bundle recordings

In 20 subjects the effects of controlled premature atrial stimulation on atrioventricular conduction was studied using an electrode catheter technic for recording electrical activity of specialized conducting fibers. The least common type of response observed was that in which A-V conduction delay was limited only to the A-V nodal region (type A). This type of response was obtained whenever the conduction delay in the A-V nodal region increased in direct proportion to the prematurity of a propagated atrial impulse. It was characterized by a progressive prolongation in the P-H interval with ultimate failure of conduction occurring proximal to the His bundle. In type B response, conduction delay occurred in both the A-V nodal and His-Purkinje systems. The recording of a characteristic A-V nodal potential permitted the localization of A-V nodal delay to the N-H interval.