Daily Archive 03.12.2018

ECG with extrasystole from AV connection

ECG with extrasystole from AV connection

The extrasystoles arising in AV connection were called “nodal” earlier. It is now recognized that at least part of the AV node does not have automatic (pacemaker) activity and is not able to generate pulses, and that extrasystoles arising in the AV node cannot be distinguished from those whose source is in the His bundle.

In this connection, the more general term “extrasystoles from an AV connection” is used. Extrasystoles from the AV connection are less common atrial and ventricular. The need for treatment is rare.

Electrocardiographic manifestations. About an ekstrasistoliya from an AV-connection speak, if on the electrocardiogram the premature QRS complex having the same configuration, as sinus complexes is found.

The focus located in the AV junction can activate both the atria and the ventricles, which leads to the appearance of a retrograde P wave (ie, a negative P wave in leads II, III, aVF).

At the same time, the retrograde P wave can either precede the QRS complex, or be recorded after it or merge with it, depending on the ratio of the speeds of the premature pulse from the AV connection to the ventricles and the atria.