1. (1) Attention is drawn to regrettable inconsistencies in usage of the terms dissociation, escape, and interference. The senses in which interference has been mainly used are detailed and discussed. 2. (2) The early history of A-V dissociation (interference-dissociation) is traced, especially as it exemplifies usage of the terms dissociation and interference. In the interest of clarity it is urged that A-V dissociation be reserved for this arrhythmia and be not applied to complete A-V block. By so reserving it, and by eschewing the maltreated term interference, much of the existing terminologic confusion could be avoided. 3. (3) Reasons are given for regarding interference-dissociation, dissociation with interference, complete dissociation, and incomplete dissociation as now unsatisfactory terms. It is recommended that A-V dissociation be simply divided into dissociation with and dissociation without ventricular capture. 4. (4) None of the six criteria often regarded as characteristic of A-V dissociation (sinus control of atria, nodal control of ventricles, independence between atria and ventricles, ventricles beating faster than atria, presence of retrograde block, normal forward conduction) is essential to the definition of this arrhythmia; indeed, exceptions to these terms are numerous. Such exceptions are illustrated and discussed and an attempt is made to redefine A-V dissociation. 5. (5) Interference (in one sense) is sometimes regarded as the cause of dissociation. It can be argued, however, that the principium of dissociation is not interference (in any sense); rather the original sin is the dysrhythmic whim of a truant (defaulting) or insubordinate (usurping) pacemaker. 6. (6) The incidence and significance of A-V dissociation is briefly commented upon. In a series of 10,000 consecutive tracings in a general hospital, this arrhythmia was diagnosed 48 times (0.48 per cent or one in every 208 records). It occurred mainly in elderly patients with severe degenerative cardiovascular disease.

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insubordinate usurping pacemaker principium of ventricles independence between atria and ventricles ventricles complete dissociation dysrhythmic whim of atria nodal ventricular capture truant defaulting of retrograde block normal forward

Henry J.L. Marriott and Adalbert F. Schubart and Samuel M. Bradley,.A-V dissociation: A reappraisal∗. 2 (5),586-605.

Henry J.L. Marriott and Adalbert F. Schubart and Samuel M. Bradley,"A-V dissociation: A reappraisal∗" 2

Henry J.L. Marriott and Adalbert F. Schubart and Samuel M. Bradley,"A-V dissociation: A reappraisal∗"