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Unique Rhythm Phenomena and Mechanisms

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Management of Cardiac Arrhythmias

Part of the book series: Contemporary Cardiology ((CONCARD))

Abstract

It is of critical importance in clinical cardiology practice to recognize unique rhythm phenomena and understand the underlying mechanisms as well as the associated clinical implications. Our primary objective in this chapter thus is to discuss several specific rhythm phenomena, which are unique, but also commonly seen in clinical practice. We have chosen to highlight the Ashman phenomenon, cardiac (T wave) memory, concealed conduction, gap phenomenon, phase 3 block, phase 4 block and Inverse Wenckebach (not traditionally defined Reverse Wenckebach), supernormal conduction, and Wedensky phenomenon. Recent progress in both basic and clinical research has provided new insights into these unique rhythm phenomena. Three examples of such revelations include 1) novel evidence of Wenckebach conduction (at a cellular level) in ventricular myocardium; 2) Inverse Wenckebach, a newly observed ECG phenomenon that is associated with paroxysmal AV block; and 3) cardiac (T wave) memory, a misleading ECG phenomenon and concept that has caused tremendous confusion in clinical practice.

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Authors and Affiliations

  1. Department of Electrophysiology, TEDA International Cardiovascular Hospital, Tianjin, China

    Jianyong Wang

  2. Department of Cardiology, Paoli Hospital, Paoli, PA, USA

    Matthew A. Goldstein

  3. Department of Cardiology, Lankenau Institute for Medical Research and Lankenau Medical Center, Wynnewood, PA, USA

    Gan-Xin Yan

  4. Sidney Kimmel College of Medicine, Thomas Jefferson University, Philadelphia, PA, USA

    Gan-Xin Yan

  5. Department of Cardiology, Fuwai Huazhong Hospital, Zhengzhou, China

    Gan-Xin Yan

Authors
  1. Jianyong Wang
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  2. Matthew A. Goldstein
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  3. Gan-Xin Yan
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Corresponding author

Correspondence to Gan-Xin Yan .

Editor information

Editors and Affiliations

  1. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Gan-Xin Yan

  2. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Peter R. Kowey

  3. Lankenau Heart Institute, Thomas Jefferson University, Wynnewood, PA, USA

    Charles Antzelevitch

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Wang, J., Goldstein, M.A., Yan, GX. (2020). Unique Rhythm Phenomena and Mechanisms. In: Yan, GX., Kowey, P., Antzelevitch, C. (eds) Management of Cardiac Arrhythmias. Contemporary Cardiology. Humana, Cham. https://doi.org/10.1007/978-3-030-41967-7_4

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  • DOI: https://doi.org/10.1007/978-3-030-41967-7_4

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  • Publisher Name: Humana, Cham

  • Print ISBN: 978-3-030-41966-0

  • Online ISBN: 978-3-030-41967-7

  • eBook Packages: MedicineMedicine (R0)

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