Document Detail

Nodal and infranodal atrioventricular conduction block: Electrophysiological basis to correlate the ECG findings.
MedLine Citation:
PMID:  23647904     Owner:  NLM     Status:  In-Data-Review    
A 68-year-old woman with a history of dilated non-ischemic cardiomyopathy presented with syncope. The index ECG showed sinus rhythm with left bundle branch block. On telemetry episodes of sinus rhythm with narrower QRS complexes conduced in 2:1 pattern were noted. Invasive electrophysiological study was performed to determine cause of syncope. Normal conduction up to the AV node with an AH interval of 79 ms (normal = 55-125 ms) was observed. However, every alternate sinus beat was blocked after the inscription of His deflection (infra-Hisian block). The narrow beats conducted through the His bundle with HV intervals of 54 ms (normal = 35-55 ms). When 1:1 conduction resumed further abnormality of the His-Purkinje conduction system became evident with a QRS morphology that of an LBBB and prolongation of HV interval (HV = 96 ms). Criteria to differentiate nodal versus infranodal block based on electrophysiological properties of the nodal and infranodal system are discussed.
Bharat K Kantharia; Arti N Shah
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Publication Detail:
Type:  Journal Article     Date:  2013-02-24
Journal Detail:
Title:  Indian heart journal     Volume:  65     ISSN:  0019-4832     ISO Abbreviation:  Indian Heart J     Publication Date:    2013 Mar-Apr
Date Detail:
Created Date:  2013-05-07     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0374675     Medline TA:  Indian Heart J     Country:  India    
Other Details:
Languages:  eng     Pagination:  229-31     Citation Subset:  IM    
Copyright Information:
Copyright © 2013 Cardiological Society of India. Published by Elsevier B.V. All rights reserved.
Professor of Medicine, The University of Texas-Health Science Center at Houston, 6431 Fannin Street, Suite MSB 1.246, Houston, TX 77030, USA; Director, Clinical Cardiac Electrophysiology Fellowship Training Program, 6431 Fannin Street, Suite MSB 1.246, Houston, TX 77030, USA; Director, Cardiac Electrophysiology Laboratories-Memorial Hermann Hospital, 6431 Fannin Street, Suite MSB 1.246, Houston, TX 77030, USA. Electronic address:
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