Abstract
Tachycardia resulting from a doubling of the sinus rate by interpolated His bundle extrasystoles is described. The patient was a middle-aged diabetic man who experienced left ventricular failure on two occasions. Diagnostic criteria heretofore used for diagnosis of so-called main-stem extrasystole are reviewed. It is suggested that recording of atrioventricular node and His bundle potontials is indispensable to the localization of the site of impulse formation and that the clinical electrocardiogram may be incapable of differentiating His bundle from atrioventricular node extrasystoles. Early appearance of the extrasystole within a cardiac cycle favors the main-stem origin of the ectopic impulse.
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