| Misleading ECG appearance of AV block due to concealed AV nodal conduction caused by interpolated ventricular ectopic beats. | |
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MedLine Citation:
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PMID: 19553746 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Concealed conduction commonly occurs when a retrogradely conducted interpolated ectopic impulse enters the atrioventricular (AV) node; thus, the next sinus beat is not conducted to the ventricle or conducted with a prolonged PR interval because of increased refractoriness of AV conduction system. A 67-year-old man had complaints of exertional fatigue and palpitations at rest. His blood pressure was 110/70 mmHg and heart rate was 78 beats/min. Auscultation revealed a mild systolic murmur at the apex and an irregular rhythm. His electrocardiogram was normal, except for the presence of frequent premature ventricular complexes (PVC) of right bundle branch block morphology. Echocardiographic examination showed only grade-1 mitral regurgitation. Further evaluation with 24-h Holter monitoring showed frequent interpolated PVCs in bigeminal rhythm. Progressive prolongation of the PR interval was observed after each PVC, which ended with Mobitz type I AV block. The patient was treated with metoprolol which resulted in immediate and marked improvement in the symptoms. Control Holter recording showed very rare PVCs, without PR prolongation or AV block. |
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Authors:
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Hasan Ari; Selma Ari; Vedat Koca; Tahsin Bozat |
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Publication Detail:
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Type: Case Reports; Journal Article |
Journal Detail:
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Title: T?rk Kardiyoloji Derne?i ar?ivi : T?rk Kardiyoloji Derne?inin yay?n organ?d?r Volume: 37 ISSN: 1016-5169 ISO Abbreviation: Turk Kardiyol Dern Ars Publication Date: 2009 Apr |
Date Detail:
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Created Date: 2009-06-25 Completed Date: 2010-04-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9426239 Medline TA: Turk Kardiyol Dern Ars Country: Turkey |
Other Details:
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Languages: eng Pagination: 197-200 Citation Subset: IM |
Affiliation:
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Department of Cardiology, Bursa Postgraduate Hospital, Bursa, Turkey. hasanari03@yahoo.com |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Aged Anti-Arrhythmia Agents / therapeutic use Atrioventricular Block / etiology* Auscultation Blood Pressure Electrocardiography / methods* Electrocardiography, Ambulatory Heart Murmurs / diagnosis Heart Rate Humans Male Metoprolol / therapeutic use Ventricular Premature Complexes / diagnosis*, physiopathology, therapy |
| Chemical | |
Reg. No./Substance:
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0/Anti-Arrhythmia Agents; 37350-58-6/Metoprolol |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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