[Paroxysmal atrioventricular block during coronary revascularization with ultrasound. A case report]

The authors report the case of advanced atrioventricular block during a procedure of right coronary revascularisation with ultrasound. The different possible physiopathological mechanisms are discussed. Although no formal conclusions can be drawn, certain features suggest a paroxysmal nodal conduction defect secondary to transient parasympathetic stimulation by the ultrasound, a stimulation triggered by a Bezold-Jarish type of cardiac reflex or by direct local excitation of vagal fibres of the atrioventricular node.