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Research Article Free access | 10.1172/JCI107253

Transverse Spread and Longitudinal Dissociation in the Distal A-V Conducting System

Robert J. Myerburg, Kristina Nilsson, Benjamin Befeler, Agustin Castellanos Jr., and Henry Gelband

Medical Service, Veterans Administration Hospital, Miami, Florida 33125

Department of Medicine, University of Miami School of Medicine, Miami, Florida 33125

Department of Physiology, University of Miami School of Medicine, Miami, Florida 33125

Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33125

Find articles by Myerburg, R. in: PubMed | Google Scholar

Medical Service, Veterans Administration Hospital, Miami, Florida 33125

Department of Medicine, University of Miami School of Medicine, Miami, Florida 33125

Department of Physiology, University of Miami School of Medicine, Miami, Florida 33125

Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33125

Find articles by Nilsson, K. in: PubMed | Google Scholar

Medical Service, Veterans Administration Hospital, Miami, Florida 33125

Department of Medicine, University of Miami School of Medicine, Miami, Florida 33125

Department of Physiology, University of Miami School of Medicine, Miami, Florida 33125

Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33125

Find articles by Befeler, B. in: PubMed | Google Scholar

Medical Service, Veterans Administration Hospital, Miami, Florida 33125

Department of Medicine, University of Miami School of Medicine, Miami, Florida 33125

Department of Physiology, University of Miami School of Medicine, Miami, Florida 33125

Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33125

Find articles by Castellanos, A. in: PubMed | Google Scholar

Medical Service, Veterans Administration Hospital, Miami, Florida 33125

Department of Medicine, University of Miami School of Medicine, Miami, Florida 33125

Department of Physiology, University of Miami School of Medicine, Miami, Florida 33125

Department of Pediatrics, University of Miami School of Medicine, Miami, Florida 33125

Find articles by Gelband, H. in: PubMed | Google Scholar

Published April 1, 1973 - More info

Published in Volume 52, Issue 4 on April 1, 1973
J Clin Invest. 1973;52(4):885–895. https://doi.org/10.1172/JCI107253.
© 1973 The American Society for Clinical Investigation
Published April 1, 1973 - Version history
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Abstract

Isolated preparations of portions of the canine intraventricular conducting system were studied by microelectrode techniques in order to determine the nature of transverse spread and longitudinal dissociation of impulses in bundle branches and false tendons. Driving stimuli were delivered to an eccentric location on normal conducting tissue, and the arrival times of the propagating impulses were mapped along the length and width of the bundle branch, or along the false tendon ipsilateral and contralateral to the site of stimulation. The difference between the arrival times on the two sides was found to decrease progressively as a function of distance from the site of stimulation, the data suggesting that transverse spread of impulses involves propagation through transverse crossover points between the longitudinally oriented conducting elements. Impulses originating eccentrically became uniformly conducted across the transverse axis of bundle branches 8-15 mm from the level of the stimulating electrode, and of false tendons 2-4 mm from the stimulus site. True longitudinal dissociation, producing conduction maps different from those representing normal transverse propagation, was seen occasionally in tissue having longitudinally oriented strips of abnormal tissue. However, early premature stimulation commonly resulted in longitudinal temporal dissociation of the premature responses, possibly due to functional block in the transverse crossover fibers.

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