Abstract：
:A case of paroxysmal bradycardia- and tachycardia-dependent atrioventricular (AV) block is described in a patient with right bundle branch block. The His bundle recordings demonstrated the site of the AV block to be distal to the His bundle recording site (probably in the left bundle branch). Whereas AV block distal to the His bundle occurred at an atrial paced cycle length of 700 ms, intact ventriculoatrial (VA) conduction was present up to a ventricular paced cycle length of 400 ms. Resumption of AV conduction was dependent on a critical HH or RH (in case of escapes) interval. These findings suggest that the bradycardia-dependent block is related to a time-dependent decrease in the amplitude of the current intensity of the proximal segment during late diastole. Spontaneous diastolic depolarization during late diastole resulted in impaired anterograde (AV) conduction but facilitated retrograde (VA) conduction. These findings are consistent with experimental "in vitro" observation in the sucrose gap model of AV block.
journal_name
J Am Coll Cardioljournal_title
Journal of the American College of Cardiologyauthors
Denes P,Murabit I,Ezri M,Eybel Cdoi
10.1016/s0735-1097(87)80402-3subject
Has Abstractpub_date
1987-02-01 00:00:00pages
446-9issue
2eissn
0735-1097issn
1558-3597pii
S0735-1097(87)80402-3journal_volume
9pub_type
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更新日期：1991-12-01 00:00:00
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更新日期：2016-04-05 00:00:00
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更新日期：2012-02-14 00:00:00
