Document Detail


Atrioventricular block with 4:2 conduction pattern: what is the mechanism?
MedLine Citation:
PMID:  19570547     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We present the case of a 72-year-old man who was admitted because of acute ST-segment elevation myocardial infarction and presented with second-degree atrioventricular block with 4:2 conduction. We propose 3 alternative explanations for such an unusual conduction pattern: (1) supernormal conduction, (2) 2-level block with 4:1 conduction ratio in the upper level and 3:2 conduction ratio in the lower level, and (3) presence of 2 populations of Purkinje cells in the remaining, critically injured fascicle, one with the phase-3 block and the other with slow diastolic depolarization, leading, during a pause after the first nonconducted P, to phase-4 block.
Authors:
Marek Jastrzebski; Piotr Kukla
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Publication Detail:
Type:  Case Reports; Journal Article     Date:  2009-06-30
Journal Detail:
Title:  Journal of electrocardiology     Volume:  42     ISSN:  1532-8430     ISO Abbreviation:  J Electrocardiol     Publication Date:    2009 Nov-Dec
Date Detail:
Created Date:  2009-10-26     Completed Date:  2010-01-27     Revised Date:  2010-08-30    
Medline Journal Info:
Nlm Unique ID:  0153605     Medline TA:  J Electrocardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  684-6     Citation Subset:  IM    
Affiliation:
1st Department of Cardiology and Hypertension, University Hospital, ul. Kopernika 17, Krakow, Poland. mcjastrz@cyf-kr.edu.pl
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MeSH Terms
Descriptor/Qualifier:
Aged
Atrioventricular Block / classification,  diagnosis*
Diagnosis, Differential
Electrocardiography / methods*
Humans
Male
Comments/Corrections
Comment In:
J Electrocardiol. 2010 Sep-Oct;43(5):466-7   [PMID:  20102771 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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