| Title | Atrioventricular block with 4:2 conduction pattern: what is the mechanism? | | Author(s) | Jastrzebski M, Kukla P | | Institution | 1st Department of Cardiology and Hypertension, University Hospital, Krakow, Poland. | | Source | J Electrocardiol 2009 Jun 29. | | Abstract | 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. | | Language | ENG | | Pub Type(s) | JOURNAL ARTICLE
| | PubMed ID | 19570547 |
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