Abstract
The effect of ventricular premature contractions on atrioventricular (A–V) conduction of the following sinus beat was studied in 25 patients with use of His bundle electrography. Facilitation of A–V conduction (shortening of the A–H interval) in the postextrasystolic beat was observed in 17 patients. This facilitation was believed to be due to a longer recovery period of the A–V node after its premature retrograde (and frequently concealed) depolarization by the ventricular premature contraction. Slowing of A–V conduction (prolongation of the A–H interval) after interpolated or repetitive ventricular premature contractions occurred in five patients. In these instances, after retrograde depolarization by the ventricular premature contraction, the A–V node was still partially refractory and conduction of the postextrasystolic beat was delayed. Retrograde P waves without resetting of the A–V node were documented; in these cases, the interval after the retrograde P wave was fully compensatory, suggesting retrograde and antegrade sinoatrial block.
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