Related Experiment Video
Updated: Nov 6, 2025

Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice
Published on: June 29, 2022
Sudden unexpected improvement in the atrioventricular conduction. What is the mechanism?
Anunay Gupta1, Kartikeya Bhargava2, Dinkar Bhasin1
1Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Abstract:
The 12-lead electrocardiogram (ECG) of a 79-year-old male patient with recurrent pre-syncope showed irregular sinus rhythm with constant PR interval and left bundle branch block (LBBB) with intermittently blocked P waves. The beat following the blocked P wave had a narrower QRS with a shorter PR interval. The phenomenon of bilateral bundle branch block explains the sudden improvement in the atrioventricular conduction.
Related Concept Videos
Mechanism of Cardiac Arrhythmias
Conduction System of the Heart
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
Conduction System of the Heart
This system relies on the unique properties of nodal and Purkinje cells:...
Electrophysiology of Normal Cardiac Rhythm
The Cardiac Cycle
The Process
Electrical signals—sent from the sinoatrial (SA) node in the right atrial wall to the atrioventricular (AV) node between the right atrium and right ventricle—cause both atria to simultaneously contract. When the signal reaches the AV node, it pauses for approximately a tenth of a second, allowing the atria to contract and...
Disturbances in Heart Rhythm
Arrhythmias are categorized by their speed, rhythm, and origin. A slow heart...

