Sudden unexpected improvement in the atrioventricular conduction. What is the mechanism?

Anunay Gupta; Kartikeya Bhargava; Dinkar Bhasin; Sourabh Agstam; Hermohander Singh Isser

doi:10.1016/j.ipej.2021.05.001

Sudden unexpected improvement in the atrioventricular conduction. What is the mechanism?

Indian Pacing Electrophysiol J. 2021 Jul-Aug;21(4):248-250. doi: 10.1016/j.ipej.2021.05.001. Epub 2021 May 8.

Authors

Anunay Gupta¹, Kartikeya Bhargava², Dinkar Bhasin¹, Sourabh Agstam¹, Hermohander Singh Isser³

Affiliations

¹ Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
² Department of Cardiology, Medanta-The Medicity, Gurugram, India.
³ Department of Cardiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India. Electronic address: drhsisser@gmail.com.

Abstract

The 12-lead electrocardiogram (ECG) of a 79-year-old male patient with recurrent pre-syncope showed irregular sinus rhythm with constant PR interval and left bundle branch block (LBBB) with intermittently blocked P waves. The beat following the blocked P wave had a narrower QRS with a shorter PR interval. The phenomenon of bilateral bundle branch block explains the sudden improvement in the atrioventricular conduction.

Keywords: Bilateral bundle branch block; Electrocardiogram; LBBB; Ladder diagram.

Publication types

Case Reports