Abstract
This report describes a case of distal AV block with a 2/1 conduction in basal conditions. Atrial stimulation induced an alternating Wenckebach phenomenon (AWP), always distal to the His bundle spike, with 8/3 or 6/2 conduction at an atrial rate of 88/min, and 12/3, 8/2 or 9/2 conduction at 130/min. Models for these conduction disturbances are presented, based on previous work on AW in the AV node. The clinical significance of the distal AWP is discussed.
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