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Published on: December 11, 2017
Reverse Wenckebach Phenomenon After Surgical Repair of Bicuspid Aortic Valve: Long-Term Follow-Up
Cui-Xiong Jin1, Yi-Ming Zhu1, Xiao-Gang Guo2
1Fuwai Yunnan Hospital, Chinese Academy of Medical Sciences/Affiliated Cardiovascular Hospital of Kunming Medical University, Kunming, China.
Background:
The Wenckebach phenomenon of atrioventricular conduction is deemed a physiological response of the atrioventricular node to a high atrial rate. However, the reverse Wenckebach phenomenon is under-recognized.
Case Summary:
We report an instance of reverse Wenckebach phenomenon developing into complete heart block in a 33-year-old man who experienced syncope after surgical repair of prolapsed bicuspid aortic valves. His condition was managed by temporary pacing. However, long-term follow-up demonstrated that the reverse Wenckebach phenomenon and severe heart block was reversible, avoiding the need for a permanent pacemaker.
Discussion:
Reverse Wenckebach phenomenon can occur spontaneously and degenerate to complete heart block. Combined with our findings, early recognition and prompt intervention may save the patient at risk.
Take-Home Messages:
The reverse Wenckebach phenomenon paradoxically indicates an atrioventricular block at the intra-Hisian or infra-Hisian level, heralding a more severe atrioventricular block in the near future. This phenomenon after valve surgery may be temporary.
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