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Mechanism of QRS electrical alternans.
  1. B. Brembilla-Perrot,
  2. H. Lucron,
  3. F. Schwalm,
  4. A. Haouzi
  1. Cardiology A, University Hospital of Brabois, Vandoeuvre, France.


    In patients with latent dual atrioventricular nodal pathways a 2:1 ventriculoatrial block often occurs during ventricular pacing and is generally associated with the concomitant appearance of QRS alternans. This type of QRS alternans is related to retrograde conduction, and a concealed retrograde conduction in the His Purkinje system could explain the QRS alternans. A case that confirms the hypothesis that electrical alternans is secondary to a 2:1 block in the activation of some part of the ventricles is reported.

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