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  • Title: Inducible atrioventricular nodal reentrant echo behind organic 2:1 infra-hisian block during sinus rhythm.
    Author: Chu CS, Lee KT, Lai WT.
    Journal: Pacing Clin Electrophysiol; 2006 Mar; 29(3):323-6. PubMed ID: 16606402.
    Abstract:
    A 77-year-old male patient with an intermittent 2:1 infra-Hisian block during sinus rhythm was presented with dizziness and near-syncope. During electrophysiological (EP) study, dual atrioventricular (AV) nodal pathways and retrograde fast pathway were easily induced by atrial and ventricular programmed stimulation, respectively. A typical slow-fast AV nodal reentrant echo beat also could be demonstrated by single atrial extrastimulation. Atrioventricular nodal reentrant tachycardia (AVNRT) can occasionally exhibit 2:1 AV block. Conversely, AV nodal reentry property had been rarely reported behind 2:1 infra-Hisian block. The EP presentation from this case may support the notion that tissues below the His are not part of the reentrant circuit of AVNRT.
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