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Catheter‐induced A‐V Nodal Block Occurring during Electrophysiologic Study
Author(s) -
PETERS ROBERT W.,
NUSSBAUM STAN,
MAILHOT JAMES,
LIEF LAURENCE H.,
PALEY HYMAN W.
Publication year - 1984
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1984.tb04893.x
Subject(s) - medicine , catheter , bundle of his , block (permutation group theory) , nodal , sinus (botany) , cardiology , coronary sinus , electrical conduction system of the heart , electrocardiography , surgery , combinatorics , botany , mathematics , biology , genus
We describe a patienl who underwent electrophysiologic study for evaluation of recurrent syncope. No abnormalities were found but high‐grade A‐V block proximal to the A‐V bundle depolarization developed abruptly as the coronary sinus electrode catheter was being withdrawn. The A‐V block disappeared gradually over a 12‐hour period, progressing to type I second‐degree A‐V block, and then to first‐degree A‐V block (due to prolonged A‐V nodal conduction), prior to resuming normal conduction. We postulate that A‐V block was induced by direct contact between the electrode catheter and the A‐V node or very proximal His bundle. Catheter‐induced A‐V block at this site has been described only rarely, possibly because of the relatively protected location and the configuration of the A‐V node.