Skip to main content
SpringerLink
Log in

The Short PR Interval

  • Chapter
What’s New in Electrocardiography

Abstract

The normal PR (PQ) interval exceeds 0.12 s and encompasses the delay in cardiac conduction from the right atrium in the area of the sinoatrial node to the point of earliest activation of the ventricles. Up to 2% of normal persons have PR intervals from 0.10 to 0.12 s[1] and represent one end of the normal distribution. The measurement of the true PR interval is subject to an error of ±0.02 s at the usual paper speed of 25 mm/s used for routine electrocardiography using a single-channel electrocardiogram for measurement [2]. Rarely a short PR interval may be observed during isorhythmic AV dissociation [3] and in a variety of rare lysosomal storage diseases where it is believed to result from infiltration of individual AV nodal fibers with substrate [4–7]. It has been described in hyperthyroidism, anxiety neurosis, hypertension, and several other conditions where there appears to be a common underlying mechanism of increased sympathetic tone or circulating catecholamines [1].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Log in via an institution
eBook
USD 16.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD 109.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Sherf D, Cohen J: The atrioventricular node and selected cardiac arrhythmias. New York, Grune and Stratton, 1964.

    Google Scholar 

  2. White PD, Leach CE, Fotte SA: Errors in measurement of the P-R (P-Q) interval and ORS duration in the electrocardiogram. Am Heart J 22:321–328, 1941.

    Article  Google Scholar 

  3. Caracta AR, Damato AN, Gallagher JJ, Josephson ME, Varghese PJ, Lau SH, Westura EE: Electrophysiologic studies in the syndrome of short P-R interval, normal QRS complex. Am J Cardiol 31:245–253, 1973.

    Article  PubMed  CAS  Google Scholar 

  4. Keith J, Sass-Kortsak A: Glycogen storage disease of the heart. In: Keith JD, Rowe RD, Vlad P (eds). Heart disease in infancy and childhood. New York, Macmillan, 1978, pp 991–994.

    Google Scholar 

  5. Rodriquez-Torres R, Schneck L, Klienberg W: Electrocardiographic and biochemical abnormalities in Tay-Sachs disease. Bull NY Acad Med 47:717–730, 1971.

    Google Scholar 

  6. Roudebush CP, Foerster JM, Bing OHL: The abbreviated PR interval of Fabry’s disease. N Engl J Med 289:357–358, 1973.

    Article  PubMed  CAS  Google Scholar 

  7. Mehta J, Desnick RJ: Abbreviated PR interval in mannosidosis. J Pediatr 92:599–601, 1978.

    Article  PubMed  CAS  Google Scholar 

  8. Batsford WP, Akhtar M, Caracta AR, Josephson ME, Seides SF, Damato AN: Effect of atrial stimulation site on the electrophysiological properties of the atrioventricular node in man. Circulation 50:283–292, 1974.

    PubMed  CAS  Google Scholar 

  9. Agha AS, Befeler B, Castellanos AM, Sung RJ, Castillo CA, Mverbürg RJ, Castellanos A: Bipolar catheter electrograms for study of retrograde atrial activation pattern in patients without preexcitation syndromes. Br Heart J 38:641–645, 1976.

    Article  PubMed  CAS  Google Scholar 

  10. Damato AN, Lau AH: Clinical value of the electrogram of the conduction system. Prog Cardiovasc Dis 13:119–140, 1970.

    Article  PubMed  CAS  Google Scholar 

  11. Gould L, Ramana Reddy CV, Chua W, Swamy C, Dorismond JC: The syndrome of normal electrocardiograms, accessory pathways and paroxysmal tachycardias. J Electrocardiol 10:157–164, 1977.

    Article  PubMed  CAS  Google Scholar 

  12. Seipel L, Breithardt G, Both A: Atrioventricular (AV) and ventriculoatrial (VA) conduction pattern in patients with short P-R interval and normal QRS complex. In: Luderitz B (ed) Cardiac pacing -diagnostic and therapeutic tools. Heidelberg, Springer, 1976, pp 152–163.

    Google Scholar 

  13. Josephson ME, Seides SF: Clinical cardiac electrophysiology. Techniques and interpretations. Philadelphia, Lea and Febiger, 1979.

    Google Scholar 

  14. Denes P, Wu D, Rosen KM: Demonstration of dual A-V pathways in a patient with Lown-Ganong-Levine syndrome. Chest 65:343–346, 1974.

    PubMed  CAS  Google Scholar 

  15. Bissett JK, de Soyza N, Kane JJ, Murphy ML: Altered refractory periods in patients with short P-R intervals and normal QRS complex. Am J Cardiol 35:487–491, 1975.

    Article  PubMed  CAS  Google Scholar 

  16. Iannone LA: Electrophysiology of atrial pacing in patients with short P-R interval, normal QRS complex. Am Heart J 89:74–78, 1975.

    Article  PubMed  CAS  Google Scholar 

  17. Gallagher JJ, Pritchett EL, Sealy WC, Kasell J, Wallace AG: The preexcitation syndromes. Prog Cardiovasc Dis 20:285–327. 1978.

    Article  PubMed  CAS  Google Scholar 

  18. Pahlajani DB, Miller RA. Serratto M: Patterns of atrioventricular conduction in children. Am Heart J 90:165–171, 1975.

    Article  PubMed  CAS  Google Scholar 

  19. Kennelly BM, Lane GK: Electrophysiological studies in four patients with atrial flutter with 1:1 atrioventricular conduction. Am Heart J 96:723–730, 1978.

    Article  PubMed  CAS  Google Scholar 

  20. Wu D, Denes P, Dhingra R, Khan A, Rosen KM: The effects of propranolol on induction of A-V nodal reentrant paroxysmal tachycardia. Circulation 50:665–677, 1974.

    PubMed  CAS  Google Scholar 

  21. Wu D, Wyndham C, Amat-y-Leon F, Denes P, Dhingra RC, Rosen KM: The effects of ouabain on induction of atrioventricular nodal reentrant paroxysmal supraventricular tachycardia. Circulation 52:201–207, 1975.

    PubMed  CAS  Google Scholar 

  22. Lown B, Ganong WF, Levine SA: The syndrome of short P-R interval, normal QRS complex and paroxysmal rapid heart action. Circulation 5:693–706, 1952.

    PubMed  CAS  Google Scholar 

  23. Befeler B, Castellanos A, Aranda J, Gutierrez R, Lazzaro R: Intermittent bundle branch block in patients with accessory atrio-His or atrio-AV nodal pathways. Variants of the Lown-Ganong-Levine syndrome. Br Heart J 38:173–179, 1976.

    Article  PubMed  CAS  Google Scholar 

  24. Durrer D: Electrical aspects of human cardiac activity: a clinical physiological approach to excitation and stimulation. Cardiovasc Res 2:1–18, 1968.

    Article  PubMed  CAS  Google Scholar 

  25. Castellanos A Jr, Castillo CA, Agha AS, Tessler BS: His bundle electrograms in patients with short P-R intervals, narrow QRS complexes and paroxysmal tachycardias. Circulation 43:667–678, 1971.

    PubMed  Google Scholar 

  26. Mandel WJ, Danzig R, Hayakawa H: Lown-Ganong-Levine syndrome. A study using His bundle electrograms. Circulation 44:696–708, 1971.

    PubMed  CAS  Google Scholar 

  27. Coumel P, Waynberger M, Fabiato A, Slama R, Aigueperse J, Bouvrain Y: Wolff-Parkinson-White syndrome. Problems in evaluation of multiple accessory pathways and surgical therapy. Circulation 45:1212–1230, 1972.

    Google Scholar 

  28. McRae JR, Wagner GS, Rogers MC, Canent RV: Paroxysmal familial ventricular fibrillation. J Pediatr 84:515–518, 1974.

    Article  PubMed  CAS  Google Scholar 

  29. Castellanos A, Vagueiro MC, Befeler B. Myerburg RJ: Syndrome of short P-R, narrow QRS and repetetive supraventricular tachyarrhythmias: the possible occurrence of the R-on-T phenomenon and the limits of this syndrome. Eur J Cardiol 2:337–342, 1975.

    PubMed  CAS  Google Scholar 

  30. Aranda J, Castellanos A, Moleiro F, Befeler B: Effects of pacing site on A-H conduction and refractoriness in patients with short P-R intervals. Circulation 53:33–39, 1976.

    PubMed  CAS  Google Scholar 

  31. Josephson ME, Kastor JA: Supraventricular tachycardia in Lown-Ganong-Levine syndrome: atrionodal versus intranodal reentry. Am J Cardiol 40:521–527, 1977.

    Article  PubMed  CAS  Google Scholar 

  32. Benditt DG, Pritchett ELC, Smith WM, Wallace AG, Gallagher JJ: Characteristics of atrioventricular conduction and the spectrum of arrhythmias in Lown-Ganong-Levine syndrome. Circulation 57:454–465, 1978.

    PubMed  CAS  Google Scholar 

  33. Narula OS: Electrophysiologic evaluation of accessory conduction pathways. In Narula OS (ed) His bundle electrocardiography and clinical electrophysiology. Philadelphia, FA Davis, pp 314–323, 1975.

    Google Scholar 

  34. Thapar MK, Gillette PC: Dual atrioventricular nodal pathways: a common electrophysiologic response in children. Circulation 60:1369–1374, 1979.

    PubMed  CAS  Google Scholar 

  35. Castellanos A Jr, Agha AS, Befeler B, Myerburg RJ: Double accessory pathways in Wolff-Parkinson-White syndrome. Circulation 51:1020–1025, 1975.

    PubMed  CAS  Google Scholar 

  36. Coumel P, Waynberger M, Gamier JC, Slama R, Bouvrain Y: Syndrome de préexcitation ventriculaire associant P-R court et onde delta, sans élargissement de QRS: (a propos de trios cas de syndrome de WPW à complexes fins). Arch Mal Couer 64:1234–1255, 1971.

    CAS  Google Scholar 

  37. Zipes DP, DeJoseph RL, Rothbaum DA: Unusual properties of accessory pathways. Circulation 49:1200–1211, 1974.

    PubMed  CAS  Google Scholar 

  38. Neuss H, Schlepper M, Spies HF: Effects of heart rate and atropine on “dual A-V conduction”. Br Heart J 37:1216–1227, 1975.

    Article  PubMed  CAS  Google Scholar 

  39. Ward DE, Camm AJ, Spurrell RAJ: Re-entrant tachycardia using two bypass tracts and excluding AV node in short PR interval, normal QRS syndrome. Br Heart J 40:1127–1133, 1978.

    Article  PubMed  CAS  Google Scholar 

  40. Bellet S, Jedlicka J: Sinoventricular conduction and its relation to sino-atrial conduction. Am J Cardiol 24:831–835, 1969.

    Article  PubMed  CAS  Google Scholar 

  41. Théry CI, Lékieffre J, Carré A, Warembourg H: Le syndrome PR court-QRS normal: Forme particulière de bloc sino-auriculaire? (Avec étude anatomique des voies de conduction.) Arch Mal Coeur 67:507–512, 1974.

    Google Scholar 

  42. Burch GE, Kimball JL: Notes on the similarity of QRS complex configurations in the Wolff-Parkinson-White Syndrome. Am Heart J 32:560–570, 1946.

    Article  PubMed  CAS  Google Scholar 

  43. James TN: Morphology of the human atrioventricular node, with remarks pertinent to its electrophysiology. Am Heart J 62:756–771, 1961.

    Article  PubMed  CAS  Google Scholar 

  44. Ferrer MI: New concepts relating to the preexcitation syndrome. JAMA 201:1038–1039, 1967.

    Article  PubMed  CAS  Google Scholar 

  45. Lev M, Leffler WB, Langendorf R, Pick A: Anatomic findings in a case of ventricular preexcitation (WPW) terminating in complete atrioventricular block. Circulation 34:718–733, 1966.

    PubMed  CAS  Google Scholar 

  46. Brechenmacher C, Laham J, Iris L, Gerbaux A, Lenègre J: Etude histologique des voies anormales de conduction dans un syndrome de Wolff-Parkinson-White et dans un syndrome de Lown-Ganong-Levine. Arch Mal Coeur 67:507–519, 1974.

    PubMed  CAS  Google Scholar 

  47. Brechenmacher C: Atrio-His bundle tracts. Br Heart J 37:853–855, 1975.

    Article  PubMed  CAS  Google Scholar 

  48. Moe GK, Preston JB, Burlington H: Physiologie evidence for a dual A-V transmission system. Circ Res 4:357–375, 1956.

    PubMed  CAS  Google Scholar 

  49. Mendez C, Moe GK: Demonstration of a dual A-V conduction system in the isolated heart. Circ Res 19:378–393, 1966.

    PubMed  CAS  Google Scholar 

Download references

Authors
  1. B. M. Kennelly
    View author publications

    You can also search for this author in PubMed Google Scholar

Editor information

Editors and Affiliations

  1. Department of Cardiology Annadal Hospital, University of Limburg, Maastricht, The Netherlands

    H. J. J. Wellens

  2. School of Medicine Division of Cardiology, University of Liège, Liège, Belgium

    H. E. Kulbertus

Rights and permissions

Reprints and permissions

Copyright information

© 1981 Martinus Nijhoff Publishers, The Hague

About this chapter

Cite this chapter

Kennelly, B.M. (1981). The Short PR Interval. In: Wellens, H.J.J., Kulbertus, H.E. (eds) What’s New in Electrocardiography. Springer, Dordrecht. https://doi.org/10.1007/978-94-009-8239-0_10

Download citation

  • DOI: https://doi.org/10.1007/978-94-009-8239-0_10

  • Publisher Name: Springer, Dordrecht

  • Print ISBN: 978-90-247-2452-9

  • Online ISBN: 978-94-009-8239-0

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics

Search

Navigation