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Related Experiment Videos

Exercise-induced second-degree atrioventricular block.

Loukas K Pappas, Michalis Efremidis, Antonios Sideris

    International Journal of Cardiology
    |August 9, 2005
    PubMed
    Summary
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    A 56-year-old woman experienced 2:1 atrioventricular (AV) block during exercise, despite normal AV conduction at rest. This paradoxical AV block resolved with increased heart rate, suggesting a gap phenomenon in the AV node.

    Area of Science:

    • Cardiology
    • Electrophysiology
    • Cardiac Electrophysiology

    Background:

    • Normal atrioventricular (AV) conduction is typically maintained during exercise.
    • Paradoxical AV block, where conduction worsens with increased heart rate, is uncommon.

    Observation:

    • A 56-year-old woman presented with normal 1:1 AV conduction at rest.
    • During treadmill exercise testing, she developed 2:1 AV block.

    Findings:

    • Electrophysiological study confirmed 2:1 AV block proximal to the His bundle.
    • 1:1 AV conduction reappeared at a higher atrial pacing rate, indicating a gap phenomenon.

    Implications:

    • The findings suggest a localized issue within the AV node, specifically a gap phenomenon, as a cause of exercise-induced paradoxical AV block.

    Related Experiment Videos

  • This case highlights the importance of considering localized AV nodal properties in understanding complex conduction abnormalities during electrophysiological studies.