{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T07:30:50Z","timestamp":1787729450201,"version":"build-2784847793"},"reference-count":0,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["Circulation"],"published-print":{"date-parts":[[1976,8]]},"abstract":"<jats:p>Reciprocating tachycardia in a patient with a leftsided atrioventricular accessory pathway (AP) (Kent bundle, type A) capable only of ventriculo-atrial (V-A) transmission is described. The V-A AP is established as an essential link of the tachycardia circuit, as evidenced by : 1) retrograde atrial activation of the left atrium (LA) 60 msec or more before the low and high right atrium during reciprocating tachycardia and during V-A conduction; 2) the absence of refractory-dependent delay in V-A conduction time with progressively premature ventricular stimulation, characteristic of retrograde conduction through an AP; and 3) the absence of antegrade conduction through the Kent bundle during sinus rhythm, reciprocating tachycardia, pacing from either atrium, or during induced atrial flutter-fibrillation. The onset of the tachycardia was unique in that it could be initiated and perpetuated during sinus rhythm, without a triggering mechanism of an atrial or ventricular extrasystole. The interplay of the following two events seemed to favor the initiation of the tachycardia: 1) shortening of the atrial cycle length causing a decrease in the refractory period of the LA and\/or the AP; and 2) the development of rate-dependent left bundle branch block, delaying impulse arrival at the ventricular end of the AP. These observations described an additional mechansim of reciprocating tachycardia in patients with the Wolff-Parkinson-White syndrome.<\/jats:p>","DOI":"10.1161\/01.cir.54.2.338","type":"journal-article","created":{"date-parts":[[2012,6,11]],"date-time":"2012-06-11T23:57:40Z","timestamp":1339459060000},"page":"338-344","update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":34,"title":["Mechanism of reciprocating tachycardia initiated during sinus rhythm in concealed Wolff-Parkinson-White syndrome: report of a case."],"prefix":"10.1161","volume":"54","author":[{"given":"R J","family":"Sung","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Castellanos","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H","family":"Gelband","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R J","family":"Myerburg","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","container-title":["Circulation"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/pdf\/10.1161\/01.CIR.54.2.338","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,12]],"date-time":"2024-05-12T13:59:27Z","timestamp":1715522367000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/01.CIR.54.2.338"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[1976,8]]},"references-count":0,"journal-issue":{"issue":"2","published-print":{"date-parts":[[1976,8]]}},"alternative-id":["10.1161\/01.CIR.54.2.338"],"URL":"https:\/\/doi.org\/10.1161\/01.cir.54.2.338","relation":{},"ISSN":["0009-7322","1524-4539"],"issn-type":[{"value":"0009-7322","type":"print"},{"value":"1524-4539","type":"electronic"}],"subject":[],"published":{"date-parts":[[1976,8]]},"assertion":[{"value":"1976-08-01","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}