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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