Abstract
In a patient with complete heart block and retrograde Ventriculoatrial conduction, His bundle electrography demonstrated (1) orthograde block beyond the bundle of His, (2) retrograde conduction through the atrioventricular (A-V) node as evidenced by retrograde P′ waves with His bundle echoes, and by the effect of idioventricular beats on subsequent sinus P wave to His bundle intervals, even in the absence of retrograde P′ waves. It is concluded that retrograde conduction can occur in complete heart block if the block is beyond the bundle of His and the A-V node is intact. The retrograde pathway around the block to the A-V node may be by muscular conduction.
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