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Compensatory accessory pathway for complete atrioventricular block: 28-year follow-up
Frédéric Sacher1, Hervé Douard, Matthew Wright
1The Hôpital Cardiologique du Haut-Lévêque, Bordeaux-Pessac, France. frederic.sacher@chu-bordeaux.fr
Pacing and Clinical Electrophysiology : PACE
|July 4, 2009
Summary
A rare case of atrioventricular (AV) block, compensated by an accessory pathway for 28 years, deteriorated leading to pacemaker implantation. Recognizing concealed AV block is crucial before radiofrequency ablation.
Area of Science:
- Cardiology
- Electrophysiology
Background:
- Atrioventricular (AV) block can be compensated by accessory pathways.
- Concealed accessory pathways may present diagnostic challenges.
Observation:
- A patient with diagnosed AV block for 28 years had a functional accessory pathway.
- Accessory pathway conduction deteriorated over time, while refractory properties remained stable.
Findings:
- The patient developed symptomatic bradycardia at age 46.
- A dual-chamber pacemaker was implanted due to progressive AV block symptoms.
Implications:
- This case highlights the importance of recognizing concealed AV block associated with accessory pathways.
- Early identification is critical to guide appropriate management and avoid complications before procedures like radiofrequency ablation.
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