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MCV/Q
MEDICAL COLLEGE OF VIRGINIA QUARTERLY
A Scientific Publication of the School of Medicine
Health Sciences Division of Virginia Commonwealth University
1973 • Volume Nine • Number One
CONTENTS
MEDICAL COLLEGE OF VIRGINIA QUARTERLY Published
quarterly (Spring, Summer, Fall, Winter), by the Medical College of Virginia, Division of Health Sciences,
Virginia Commonwealth University.
The QUARTERLY publishes results
of original research in basic and
clinical sciences. Contributions from
outside the Medical College of Virginia faculty are invited. Manuscripts,
submitted in duplicate, should be
prepared according to recommendations in the Style Manual for Biological Journals, Washington, D.C., American Institute of Biological Sciences,
Second Edition, 1964
Correspondence: MEDICAL COLLEGE OF VIRGINIA QUARTERLY, Medical College of Virginia,
Richmond, Virginia 23298. Phone
703 /770-4027.
Subscription rates for U.S.A. and
Canada: 1 year, $4.00; 2 years, $7.00;
3 years, $9.00. All other countries :
1 year, $5.00; 2 years, $8.00; 3 years
$10.00. Interns, residents, and students: 1 year, $2.00.
Third class postage paid at Richmond,
Virginia.
Editorial Advisory Board
John T. Farrar
Ernst G. Huf
Hunter M. McGuire
M. Pinson Neal, Jr.
Kinloch Nelson
Frederick J. Spencer
Editorial Consultants
Larry F. Cavazos Boston
Richard G. Lester Durham
Sarni I. Said Dallas
Malcolm E. Turner, Jr. Birmingham
Editor
Fairfield Goodale, Jr.
Editorial Assistants
Nancy S. Varmette
Stuart Gravatt
Cover Design
Raymond A. Geary
4
Cardiac Arrhythmias
Sponsored by the Council on Clinical Cardiology, the American
Heart Association, the Tidewater Heart Association, and the Virginia
Heart Association
CHARLES
L. BAIRD, JR., M .D., Guest Editor
Conducting Pathways of the Human Heart
7
FERGUS O'M. SHIEL, M.D.
FABIO GUTIERREZ, M .D .
Neural Effects on Cardiac Rate and Rhythm
H. PAGE MAUCK, JR., M.D.
11
Introduction to the Phasic Effects of the Vagus on
Sinoatrial and Atrioventricular Nodes
13
GoRDON
K. MoE, M .D., Ptt.D .
The Critical Use of the His Bundle Electrogram
15
BENJAMIN J. SCHERLAG, PH.D.
Electrophysiology of Concealed Conduction
E.
22
NEIL MOORE, D .V . M . , PH.D., F.A .C.C.
Clinical Significance of Exit Block
26
IRANY M. DE AZEVEDO, M.D.
YOSHIO WATANABE, M.D .
LEONARD S. DREIFUS, M.D.
33
Reentry
GoRDON
K. MoE, M.D., PH.D.
The Gou aux-Ashman Phenomenon: His Bundle Recordings
BENJAMIN
34
J. SCHERLAG, PH.D.
Mechanisms of Supraventricular Tachycardia
39
BENJAMIN J. SCHERLAG, PH .D.
RALPH LAZZARA, M.D.
Some Mechanisms of Supraventricular Tachycardia
GoRDON
K.
MoE, M.D., PH.D.
46
Ventricular Tachyarrhythmias
48
BoRYS SuRAw1cz, M.D.
Pharmacology of Antiarrhythmics: Quinidine, BetaBlockers, Diphenylhydantoin, Bretylium
53
ALBERT J. WASSERMAN, M .D .
JACK D . PROCTOR, M .D .
The Pharmacology and Clinical Use of Lidocaine and
Procainamide
65
J. THOMAS BIGGER, JR., M.D.
ELSA-GRACE V. GIARDINA, M .D.
The Evaluation of the Sinoatrial Node Function in Man
77
J. THOMAS BIGGER, JR., M .D.
HAROLD c. STRAUSS, M.D., C.M.
Mechanisms of A-V Block
LEONARD s. DREIFUS, M.D.
JosEPH M CMENAMIN, M .D.
DEMETRIS KIMBIRIS, M.D.
Microelectrode and His Bundle Studies on Type I and II
Second Degree A-V Block
86
92
E. NEIL MOORE, D .V.M., PH.D ., F.A.C.C.
JosEPH F. SP EA R, PH.D.
Recent Studies in the Pre-Excitation Syndrome
99
E. NEIL MOORE, D .V.M., Ptt.D., F.A.C.C.
© 1973 by
the Medical College of Virginia, Health Sciences Division of Virginia Commonwealth University
Printed by the Wi11iam B yrd Press, Richmond, Virginia
5