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  • Title: His bundle extrasystoles revisited: the great electrocardiographic masquerader.
    Author: Ameen A, Dharawat A, Khan A, Turitto G, El-Sherif N.
    Journal: Pacing Clin Electrophysiol; 2011 Jun; 34(6):e56-9. PubMed ID: 20487363.
    Abstract:
    A 74-year-old man with past history of near syncope presented with frequent periods of second-degree atrioventricular block (2° AVB). An electrophysiological study revealed prolonged atrial-His and His-ventricular (HV) intervals and frequent His bundle (H) extrasystoles. The latter manifested in the surface electrocardiogram as premature atrial, junctional, or ventricular beats, as well as 2° AVB that mimicked Wenckebach or Mobitz II block. Procainamide markedly suppressed H extrasystole. However, because of the presence of prolonged HV interval and history of presyncope, a permanent pacemaker was inserted. The case illustrates the varied manifestation of H extrasystole and presents guidelines for management.
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