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Atrioventricular dissociation

MedGen UID:
2496
•Concept ID:
C0004331
•
Pathologic Function
Synonym: A-V DISSOCIATION
SNOMED CT: Atrioventricular dissociation (50799005); Isorhythmic dissociation (50799005); Interference dissociation (50799005)
 
HPO: HP:0011709
Monarch Initiative: MONDO:0008848
OMIM®: 209600

Definition

Atrioventricular (AV) dissociation is present if the atria and the ventricles are under the control of two separate pacemakers. AV dissociation can occur in the absence of a primary AV conduction disturbance. [from HPO]

Clinical features

From HPO
Congenital atrioventricular dissociation
MedGen UID:
870839
•Concept ID:
C4025299
•
Congenital Abnormality
A form of atrioventricular (AV) dissociation (i.e., the atria and the ventricles are under the control of two separate pacemakers) with congenital onset.
See: Feature record | Search on this feature

Conditions with this feature

Congenital heart defects, multiple types, 3
MedGen UID:
767108
•Concept ID:
C3554194
•
Disease or Syndrome
Multiple types of congenital heart defects-3 (CHTD3) is an autosomal dominant condition characterized by various types of congenital heart defects and low atrial rhythm (van de Meerakker et al., 2011). For a general phenotypic description and a discussion of genetic heterogeneity of multiple types of congenital heart defects, see 306955.
See: Condition Record
Congenital heart defects, multiple types, 3

Professional guidelines

PubMed

Prenatal diagnosis and prognosis of accelerated idioventricular rhythm.
Fouron JC, McNeal-Davidson A, Abadir S, Fournier A, Bigras JL, Boutin C, Brassard M, Raboisson MJ, van Doesburg N, Berger A, Brisebois S, Gendron R
Ultrasound Obstet Gynecol 2017 Nov;50(5):624-631. doi: 10.1002/uog.17382. PMID: 27943499
The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.
Sousa PA, Pereira S, Candeias R, de Jesus I
Rev Port Cardiol 2014 Mar;33(3):165-73. Epub 2014 Mar 20 doi: 10.1016/j.repc.2013.07.016. PMID: 24656320
A simple echocardiographic method to detect atrioventricular dissociation. A useful aid in the differential diagnosis of regular tachycardia with wide QRS complexes.
Manyari DE, Ko P, Gulamhusein S, Boughner DR, Kostuk WJ, Klein GJ
Chest 1982 Jan;81(1):67-73. doi: 10.1378/chest.81.1.67. PMID: 7053944

Recent clinical studies

Etiology

Right Ventricular Outflow Tract Stenting is a Safe and Effective Bridge to Definitive Repair in Symptomatic Infants With Tetralogy of Fallot(1).
Luxford JC, Adams PE, Roberts PA, Mervis J
Heart Lung Circ 2023 May;32(5):638-644. Epub 2023 Mar 22 doi: 10.1016/j.hlc.2023.02.010. PMID: 36964005
Landiolol Hydrochloride Rapidly Controls Junctional Ectopic Tachycardia After Pediatric Heart Surgery.
Yoneyama F, Tokunaga C, Kato H, Nakajima T, Mathis BJ, Sakamoto H, Hiramatsu Y
Pediatr Crit Care Med 2018 Aug;19(8):713-717. doi: 10.1097/PCC.0000000000001573. PMID: 29677032
Prenatal diagnosis and prognosis of accelerated idioventricular rhythm.
Fouron JC, McNeal-Davidson A, Abadir S, Fournier A, Bigras JL, Boutin C, Brassard M, Raboisson MJ, van Doesburg N, Berger A, Brisebois S, Gendron R
Ultrasound Obstet Gynecol 2017 Nov;50(5):624-631. doi: 10.1002/uog.17382. PMID: 27943499
New conduction abnormalities after TAVI--frequency and causes.
van der Boon RM, Nuis RJ, Van Mieghem NM, Jordaens L, Rodés-Cabau J, van Domburg RT, Serruys PW, Anderson RH, de Jaegere PP
Nat Rev Cardiol 2012 May 1;9(8):454-63. doi: 10.1038/nrcardio.2012.58. PMID: 22547171
The spectrum of atrioventricular discordance. A clinical study.
de Albuquerque AT, Rigby ML, Anderson RH, Lincoln C, Shinebourne EA
Br Heart J 1984 May;51(5):498-507. doi: 10.1136/hrt.51.5.498. PMID: 6202308Free PMC Article

Diagnosis

High-grade atrioventricular block.
Lim Y, Singh D, Poh KK
Singapore Med J 2018 Jul;59(7):346-350. doi: 10.11622/smedj.2018086. PMID: 30109349Free PMC Article
Wide-QRS Complex Tachycardia.
Hanna EB, Johnson CJ, Glancy DL
Am J Cardiol 2018 Jan 15;121(2):275-276. Epub 2017 Oct 19 doi: 10.1016/j.amjcard.2017.09.035. PMID: 29132651
The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.
Sousa PA, Pereira S, Candeias R, de Jesus I
Rev Port Cardiol 2014 Mar;33(3):165-73. Epub 2014 Mar 20 doi: 10.1016/j.repc.2013.07.016. PMID: 24656320
Atrioventricular dissociation.
Jacobson C
AACN Adv Crit Care 2007 Apr-Jun;18(2):221-4. doi: 10.1097/01.AACN.0000269266.67782.eb. PMID: 17473551
Atrioventricular dissociation.
Harrigan RA, Perron AD, Brady WJ
Am J Emerg Med 2001 May;19(3):218-22. doi: 10.1053/ajem.2001.22657. PMID: 11326350

Therapy

Repair of atrioventricular disruption after mitral valve replacement utilizing commando procedure principles.
Raevsky E, Kwanten L, Cullen S, Stoica S
Interact Cardiovasc Thorac Surg 2022 Jul 9;35(2) doi: 10.1093/icvts/ivac179. PMID: 35775927Free PMC Article
Atypical fetal junctional ectopic tachycardia: a case report and literature review.
Katsura D, Tsuji S, Tokoro S, Hoshiyama T, Hoshino S, Furukawa O, Murakami T
BMC Pregnancy Childbirth 2022 Apr 11;22(1):311. doi: 10.1186/s12884-022-04655-6. PMID: 35410180Free PMC Article
Landiolol Hydrochloride Rapidly Controls Junctional Ectopic Tachycardia After Pediatric Heart Surgery.
Yoneyama F, Tokunaga C, Kato H, Nakajima T, Mathis BJ, Sakamoto H, Hiramatsu Y
Pediatr Crit Care Med 2018 Aug;19(8):713-717. doi: 10.1097/PCC.0000000000001573. PMID: 29677032
New conduction abnormalities after TAVI--frequency and causes.
van der Boon RM, Nuis RJ, Van Mieghem NM, Jordaens L, Rodés-Cabau J, van Domburg RT, Serruys PW, Anderson RH, de Jaegere PP
Nat Rev Cardiol 2012 May 1;9(8):454-63. doi: 10.1038/nrcardio.2012.58. PMID: 22547171
Wide-complex tachycardias. The importance of identifying the mechanism.
Janeira LF
Postgrad Med 1996 Sep;100(3):259-62, 265-6, 269-72 passim. doi: 10.3810/pgm.1996.09.81. PMID: 8795658

Prognosis

Atrioventricular Dissociation during Ventricular Fibrillation.
Salik JR, Thomas SS
N Engl J Med 2020 Jun 4;382(23):e84. doi: 10.1056/NEJMicm1916823. PMID: 32492307
Prenatal diagnosis and prognosis of accelerated idioventricular rhythm.
Fouron JC, McNeal-Davidson A, Abadir S, Fournier A, Bigras JL, Boutin C, Brassard M, Raboisson MJ, van Doesburg N, Berger A, Brisebois S, Gendron R
Ultrasound Obstet Gynecol 2017 Nov;50(5):624-631. doi: 10.1002/uog.17382. PMID: 27943499
The value of electrocardiography for differential diagnosis in wide QRS complex tachycardia.
Sousa PA, Pereira S, Candeias R, de Jesus I
Rev Port Cardiol 2014 Mar;33(3):165-73. Epub 2014 Mar 20 doi: 10.1016/j.repc.2013.07.016. PMID: 24656320
New conduction abnormalities after TAVI--frequency and causes.
van der Boon RM, Nuis RJ, Van Mieghem NM, Jordaens L, Rodés-Cabau J, van Domburg RT, Serruys PW, Anderson RH, de Jaegere PP
Nat Rev Cardiol 2012 May 1;9(8):454-63. doi: 10.1038/nrcardio.2012.58. PMID: 22547171
Interatrial abscess.
Holt S, Martinez AA, Coulshed N
Postgrad Med J 1979 Mar;55(641):207-9. doi: 10.1136/pgmj.55.641.207. PMID: 461286Free PMC Article

Clinical prediction guides

Right Ventricular Outflow Tract Stenting is a Safe and Effective Bridge to Definitive Repair in Symptomatic Infants With Tetralogy of Fallot(1).
Luxford JC, Adams PE, Roberts PA, Mervis J
Heart Lung Circ 2023 May;32(5):638-644. Epub 2023 Mar 22 doi: 10.1016/j.hlc.2023.02.010. PMID: 36964005
Standing genetic variation affects phenotypic heterogeneity in an SCN5A-mutation founder population with excess sudden cardiac death.
Isaacs A, Barysenka A, Ter Bekke RMA, Helderman-van den Enden ATJM, van den Wijngaard A, Volders PGA, Stoll M
Heart Rhythm 2023 May;20(5):720-727. Epub 2023 Feb 9 doi: 10.1016/j.hrthm.2023.02.004. PMID: 36764349
Ablation of Supraventricular Tachycardias From Concealed Left-Sided Nodoventricular and Nodofascicular Accessory Pathways.
Cardona-Guarache R, Han FT, Nguyen DT, Chicos AB, Badhwar N, Knight BP, Johnson CJ, Heaven D, Scheinman MM
Circ Arrhythm Electrophysiol 2020 May;13(5):e007853. Epub 2020 Apr 14 doi: 10.1161/CIRCEP.119.007853. PMID: 32286853
A narrow QRS tachycardia and cannon A waves: What is the mechanism?
Ali H, Epicoco G, De Ambroggi G, Lupo P, Foresti S, Cappato R
Ann Noninvasive Electrocardiol 2017 Jul;22(4) Epub 2016 Dec 23 doi: 10.1111/anec.12423. PMID: 28008694Free PMC Article
Prenatal diagnosis and prognosis of accelerated idioventricular rhythm.
Fouron JC, McNeal-Davidson A, Abadir S, Fournier A, Bigras JL, Boutin C, Brassard M, Raboisson MJ, van Doesburg N, Berger A, Brisebois S, Gendron R
Ultrasound Obstet Gynecol 2017 Nov;50(5):624-631. doi: 10.1002/uog.17382. PMID: 27943499

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