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Atrioventricular Dissociation

Douglas P. Zipes, MD; Charles Fisch, MD
Arch Intern Med. 1973;131(4):593-595. doi:10.1001/archinte.1973.00320100121018.
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Perhaps no area of electrocardiography uses terms that are more controversial and basic concepts that are subject to different interpretations than the topic, atrioventricular dissociation. Attempts to bring order out of confusion have lead to more terms and classifications, akin to the chaos surrounding cardiomyopathies. To minimize this confusion, we shall initially spend time with definitions and outline the classification we consider best.

Atrioventricular dissociation means exactly that: atria and ventricles are dissociated; they are under the control of separate pacemakers for one or more cardiac cycles. It is important to stress that the term, AV dissociation, used generically, provides no information regarding the nature of atrial or ventricular activity, except that these chambers are depolarizing independently for a period of time. Atrioventricular dissociation is "never a primary disturbance of rhythm... but rather the consequence of some other more basic disorder."1 Atrioventricular dissociation describes a situation or a symptom


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