[Paroxysmal AV block induced by atrial flutter in acute inferior myocardial infarction]

Conduction disturbances in the acute phase of an inferior myocardial infarction are frequent. Paroxysmal AV block and ventricular standstill is, on the other hand, an unusual event. We describe a case of paroxysmal AV block precipitated by, and dependent on, the presence of atrial flutter. Concealed conduction of atrial impulses to the AV node is the likely cause of this form of AV block. The transient development, ischaemia related, of a longitudinal and transverse dissociation of the AV node, increased the concealed penetration of atrial impulses and its effect on subsequent impulse formation, given rise to a form of paroxysmal AV block.