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Mind the gap.

Asaf Danon1, Yair Elitzur2, Sheldon M Singh3

  • 1Department of Cardiology, Carmel Medical Center, Haifa, Israel.

Journal of Electrocardiology
|March 30, 2017
PubMed
Summary
This summary is machine-generated.

This case study describes a woman with intermittent 2:1 atrioventricular block and a unique paradoxical conduction pattern during electrophysiological study. The findings offer insights into complex cardiac conduction abnormalities.

Keywords:
Atrioventricular blockGap phenomenonInfrahisian blockPhase 4 blockSupranormal conduction

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Cardiac Electrophysiology

Background:

  • Atrioventricular (AV) block is a common cardiac arrhythmia.
  • Intermittent 2:1 AV block can present with varying clinical manifestations.
  • ECG findings of wide QRS with right bundle branch block (RBBB) can complicate diagnosis.

Observation:

  • A case of asymptomatic intermittent 2:1 AV block in a woman is presented.
  • Baseline ECG revealed a wide QRS complex with a RBBB pattern.
  • Electrophysiological study showed a normal HV interval.

Findings:

  • A unique pattern of paradoxical conduction was observed during electrophysiological stimulation.
  • This paradoxical conduction pattern is discussed in relation to the patient's specific cardiac anatomy and electrophysiology.
  • The mechanism underlying this unusual conduction phenomenon is explored.

Implications:

  • Understanding paradoxical conduction is crucial for accurate diagnosis and management of complex AV block.
  • This case highlights the importance of electrophysiological studies in elucidating unclear cardiac conduction abnormalities.
  • Further research into paradoxical conduction mechanisms may lead to novel therapeutic strategies for arrhythmias.