What is the role of enhanced atrioventricular nodal conduction (EAVNC) in the pathophysiology of Lown-Ganong-Levine syndrome (LGL)?

Updated: Dec 09, 2020
  • Author: Daniel M Beyerbach, MD, PhD; Chief Editor: Jose M Dizon, MD  more...
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Answer

EAVNC has been investigated as a possible functional basis for LGL. [24] The criteria for EAVNC were established arbitrarily on the basis of observations of some patients with what seemed to be abnormally rapid AV nodal conduction times. However, in 1980, Bauernfeind and colleagues described a unimodal distribution of PR intervals in a series of 65 patients with AV nodal reentrant tachycardia. [25]

Further, in 1983 Jackman et al provided convincing evidence that EAVNC does not exist as a phenomenon separate from normal AV nodal physiology, but that AV nodal conduction physiology comprises a spectrum of AH intervals. [12] In their series of 160 consecutive patients, they failed to identify a distinct group of patients with abnormally rapid AV nodal conduction. Rather, they found a broad spectrum of AH intervals in a unimodal, continuous distribution. Importantly, among patients with dual pathways, patients with shorter AH intervals do have a greater likelihood of developing AV nodal reentrant tachycardia. [26]


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