Gap phenomenon
Jump to navigation
Jump to search
Template:Search infobox Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
The Gap phenomenon in AV conduction was first described as an observation during atrial extrastimulation in which AV block at longer coupling intervals is followed by restored AV conduction at shorter coupling intervals. It occurs when the initial site of block is in the distal conduction system and as the coupling interval is further decreased, a critical delay occurs in the proximal conducting site, which gives the distal site time to recover excitability. A key condition for occurrence of the gap phenomenon is that the effective refractory period of the distal site is longer than the functional refractory period of the proximal site.
| Type | Proximal Delay | Distal Delay |
|---|---|---|
| Type 1 | AVN | HPS |
| Type 2 | HPS proximal | HPS distal |
| Type 3 | His | HPS |
| Type 4 | Atrium | AVN or HPS |
| Type 5 | AVN proximal | AVN distal |
| Type | Proximal Delay | Distal Delay | |
|---|---|---|---|
| Type 1 | HPS | AVN | |
| Type 2 | HPS distal | HPS Proximal |
References
- Moe GK, Mendez C, Han J. Aberrant A-V impulse propagation in the dog heart: a study of functional bundle branch block. Circ Res 1965;16:261–286.