Retrograde Conduction to the Atria in Ventricular Tachycardia

Abstract

Ventriculo-atrial (V-A) conduction in ventricular tachycardia was recognized relatively frequently with simultaneous esophageal and standard leads. Of 21 cases of ventricular tachycardia there was 11 V-A conduction alone in 5, 1:1 V-A conduction in some runs of tachycardia with other mechanisms in other runs in 5, V-A conduction with variable block in 4, and an independent atrial rhythm alone in 7. The frequency of 1:1 V-A conduction in ventricular tachycardia complicates the differential diagnosis from supraventricular tachycardia with aberrant conduction. A bipolar esophageal lead is often superior to a V esophageal lead for the study of complex arrhythmias and V-A conduction. It is more likely than a V esophageal lead to show retrograde P waves more or less opposite in direction to the sinus P waves.