Mechanisms of Paroxysmal Supraventricular Tachycardia

Delon Wu, MD; Pablo Denes, MD
Arch Intern Med. 1975;135(3):437-442. doi:10.1001/archinte.1975.00330030087009.
Text Size: A A A
Published online

Paroxysmal supraventricular tachycardia (PSVT) is a common arrhythmia in patients with and without organic heart disease. It has generally been believed to reflect either reentrant mechanisms or rapid firing of ectopic foci. Recent clinical and experimental observations have suggested that most PSVT appears to reflect reentrance.1-6 In man, the occurrence of reentrance has been demonstrated in the sinus node,7-9 atrium,9 atrioventricular node,1-6 and possibly the His bundle.10

Longitudinal dissociation of a conducting structure (for example, the atrioventricular node) allows reentry to occur11-14 (Fig 1, left). With dissociation into two pathways, a premature impulse encounters refractoriness (unidirectional block) in one pathway and conducts slowly in the other pathway. The previously blocked pathway recovers for retrograde conduction during the period of slow conduction. If the two pathways are connected by a final common pathway, the impulse can reenter the previously blocked pathway and return to the chamber of origin. While conducting retrograde,


Sign In to Access Full Content

Don't have Access?

Register and get free email Table of Contents alerts, saved searches, PowerPoint downloads, CME quizzes, and more

Subscribe for full-text access to content from 1998 forward and a host of useful features

Activate your current subscription (AMA members and current subscribers)

Purchase Online Access to this article for 24 hours

First Page Preview

View Large
First page PDF preview





Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).
Submit a Comment


Some tools below are only available to our subscribers or users with an online account.

Sign In to Access Full Content

Related Content

Customize your page view by dragging & repositioning the boxes below.