VEB-Induced AV Block

Report:

Sinus rhythm.

VEBs

Second-degree AV block, advanced.

Junctional escape beats.

Intraventricular conduction delay, QRS 0.12".

Comment:

All the occurrences of the AV block follow the VEBs. This is “an extremely rare phenomenon”, with only three cases reported so far, including this one138. The mechanism of this type of block remains unknown. Since no instance occurred in this patient without a preceding VEB, it is not possible to assign it a Möbitz 1 or 2 mechanism. It is almost certainly significant that the patient had bilateral bundle branch block (BBBB). 202a. 203. Two-channel Holter monitor recording on a 57 year old man with anterior infarction three weeks previously. At the onset of tachycardia, he experienced palpitations, but was otherwise asymptomatic. He became pulseless in EMD when carotid sinus massage was applied (lower strip) and could not be resuscitated.

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