Objective To investigate escape rhythm with dual pathways ventriculoatrial conduction(VAC) and its electrocardiogram(ECG) characteristics and mechanisms. Methods To select 11 cases of escape rhythm with dual VAC

and to analyze their ECG data retrospectively. Results In 11 patients with escape rhythm

7 patients were junctional and 4 patients were ventricular.The frequency of the escape rhythm was relatively regular

and followed by retrograde P wave

in which 7 cases showed two kinds of forms

and 4 cases showed only one kind. There were long and short R-P interval with obvious difference(>0.06s)

the biggest increment chang in the scope of 0.11~0.38s(average 0.23±0.09s). 3 cases accompanied by single ventricular echo beat

1 case come up with atrioventricular nodal reentrant tachycardia. Conclusions Dual VAC was a kind of uncommon ECG phenomena. By means of analyzing surface ECG reasonably. we can make a primary diagnosis to retrograde dual pathways and provide evidence of guide for further electrophysiological examination.