Double irregular ventricular parasystole: rate-dependent entrance block and "supernormal" exit conduction.

An analysis of electrocardiograms from a patient with spontaneous double irregular ventricular parasystole is presented. Irregularity in one of the two parasystoles was produced by intermittence based on rate-dependent (phase 3) entrance block, and in the other parasystole it was attributed to "supernormal" exist conduction. Critical analysis of electrocardiograms revealed that first degree block, rate-dependent block, and "supernormal" conduction in the exit pathway may account for the alterations in the arrangement and manifestation of the parasystolic beats. An electrocardiographic approach to these properties of the parasystolic structure and demonstration of double ventricular parasystole with irregularity in both parasystoles has not previously been found in the literature.