Abstract
The term, “pseudoatrioventricular block,” describes an arrhythmia characterized by blocked P waves on the surface electrocardiogram, which reflects the occurrence of concealed junctional premature depolarizations. 1 Langendorf R Mehlman JS Blocked (nonconducted) A-V nodal premature systoles imitating first and second degree A-V block. Am Heart J. 1947; 34: 500-506 Abstract Full Text PDF PubMed Scopus (62) Google Scholar , 2 Rosen KM Rahimtoola SH Gunnar RM Pseudo A-V block secondary to premature nonpropagated His bundle depolarizations: Documentation by His bundle electrocardiography. Circulation. 1970; 42: 367-373 Crossref PubMed Scopus (99) Google Scholar These depolarizations are concealed because of retrograde refractoriness, with resulting absence of premature retrograde P waves, and because of anterograde refractoriness, with resulting absence of premature junctional QRS complexes; however, the concealed junctional premature activation does penetrate the atrioventricular node, so that the subsequent sinus P wave is blocked. This arrhythmia is termed “pseudoatrioventricular block,” since the blocked P wave reflects no intrinsic abnormality of conduction. The phenomenon of pseudoatrioventricular block is thus a compensatory pause seen on the surface ECG, in which the initiating premature beat is electrocardiographically silent.
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