Definition: a cardiac arrhythmia in which the impulse arising in the AV junction descends to and activates the ventricles on one intrajunctional pathway and simultaneously ascends toward the atria in parallel pathways; before reaching the atria, however, the impulse is reflected downward and again activates the ventricles, producing an echo or reciprocal beat; recognized in the electrocardiogram by the presence of an inverted P wave in lead aVF and usually II sandwiched between two ventricular complexes aberrantly, both of which may be normal or one of which may be conducted.
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