(FIT)-Module 1 Lectures: Basic Science and Fundamentals-Retrograde Conduction (Miller)

Video Transcription

Video Summary

In a video lecture from Indiana University, Professor John Miller delves into the complex subject of retrograde conduction in electrophysiology—a critical concept often overlooked. He outlines several key learning objectives, emphasizing the ability to discern the presence of retrograde conduction, recognize blockage sites within the conduction system, and differentiate between various retrograde conduction patterns. The discussion also covers distinguishing between retrograde AV node conduction versus accessory pathway conduction, and the essential knowledge for identifying his-dependent or his-independent conduction.<br /><br />Miller explains the importance of assessing retrograde conduction using tools like surface ECGs, hiss bundle recordings, and the effects of premature ventricular complexes. He details the mechanisms by which atrial activation can occur, whether through the AV node, an accessory pathway, or a combination of both, and the implications of each. By presenting scenarios of pacing at different rates and using examples of dual AV nodal pathways, the lecture provides insights into how conduction shifts occur, including the roles of catecholamines and the physiological responses of the His-Purkinje system. <br /><br />Throughout, Miller stresses the importance of understanding retrograde block dynamics and determining the site of block, emphasizing its typical location in the AV node over the His-Purkinje system.

Keywords

retrograde conduction

electrophysiology

AV node conduction

accessory pathway

His-Purkinje system

surface ECG

premature ventricular complexes

dual AV nodal pathways