Abstract

Summary The supernormal phase of intraventricular conduction was diagnosed in two patients with atrial fibrillation. In one of these cases, the predominant QRS pattern was that of right bundle-branch block; detailed study of this case (1) provided a convincing demonstration of the occurrence of supernormal conduction through the right bundle-branch, (2) showed that supernormal conduction could follow both normal and aberrant beats, (3) showed that the supernormal phase of conduction became gradually more delayed with reference to the previous QRS complex as the preceding R-R interval progressively increased in length, and (4) permitted certain deductions about probable retrograde activation of the right bundle-branch during aberrant beats. Supernormal conduction was diagnosed in a second case, presenting a predominant QRS pattern of left bundle-branch block type, but detailed analysis was not possible since the ECG recording was not sufficiently long.

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