Document Detail

Atypical Wenckebach periodicity simulating Mobitz II AV block.
MedLine Citation:
PMID:  737095     Owner:  NLM     Status:  MEDLINE    
Eleven patients were studied and a total of 144 Wenckebach cycles in the AV node and 118 Wenckebach cycles in the His-Purkinje system were analysed to determine the incidence of typical and atypical Wenckebach periodicity, with particular emphasis on one variant of atypical Wenckebach that may simulate a Mobitz type II block. This pseudo-Mobitz II pattern was defined as a long Wenckebach cycle in which, at least, the last three beats of the cycle show relatively constant PR intervals (variation of no more than 0.02 s in surface leads and no more than 10 ms in His bundle electrograms) and in which the PR interval immediately following the blocked beat is shorter than the PR interval before the block by 0.04 s or more. Atypical Wenckebach cycles were found to be more common than the typical variety at both the AV node (67%) and His-Purkinje system (69%). The pseudo-Mobitz II pattern was seen in 19 per cent of atypical AV nodal Wenckebach periods and in 17 per cent of atypical His-Purkinje system Wenckebach cycles. The need to discern a 'classical' Mobitz II block from a pseudo-Mobitz II pattern, especially in the setting of an acute inferior myocardial infarction, is emphasised.
N El-Sherif; J Aranda; B Befeler; R Lazzara
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British heart journal     Volume:  40     ISSN:  0007-0769     ISO Abbreviation:  Br Heart J     Publication Date:  1978 Dec 
Date Detail:
Created Date:  1979-04-25     Completed Date:  1979-04-25     Revised Date:  2009-11-18    
Medline Journal Info:
Nlm Unique ID:  0370634     Medline TA:  Br Heart J     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  1376-83     Citation Subset:  AIM; IM    
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MeSH Terms
Diagnosis, Differential
Heart Block / diagnosis,  physiopathology*
Heart Conduction System / physiopathology*
Middle Aged

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

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