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Updated: Dec 10, 2025

Author Spotlight: Advancing Human Cardiac Anatomy Through Multi-Scale Analysis of Hearts
Published on: June 28, 2024
Dual atrioventricular nodal pathways physiology and high-grade heart block
Behzad B Pavri1, Nicholas Ruggiero1
1Thomas Jefferson University Hospital, 111 So 11(th) Street, Philadelphia, PA 19107, United States of America.
Abstract:
We report of case of an 87 year old lady with preexisting RBBB who developed LBBB after transcatheter aortic valve replacement (TAVR) for the treatment of severe aortic stenosis. She underwent pacemaker implantation, and subsequently developed high-grade atrioventricular (AV) block. Dual chamber pacing in the setting of complete heart block with a long programmed AV delay showed retrograde P waves. Ventricular pacing showed intact retrograde conduction. Shortening the programmed AV delay resulted in loss of retrograde P waves during dual chamber pacing. These findings are discussed.
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