Abstract
The tracings obtained in long-term electrocardiographic monitoring by the Holter system.
Highlights
Several diagnostic possibilities can be inferred from the independent analysis of this tracing, from reentrant supraventricular tachycardia, such as nodal reentrant tachycardia, for example, to nonparoxysmal junctional tachycardia
In the third cycle there is an abrupt prolongation of the PR interval (560 ms),clearly characterizing the presence of dual AV nodal pathway: occurrence of conduction block in the fast pathway by being reached in its refractory period and exclusive ventricular activation by a slow pathway with a first-degree AV block of high magnitude (PR interval 560 ms).The third complex corresponds to a ventricular extrasystole
These characteristics correspond to the so-called “pseudo-pacemaker syndrome” (or pacemaker syndrome without pacemaker), that is one of the few situations in which definitive dual-chamber pacemaker implantation in supra-hisian first-degree atrioventricular block is required[3] in order to provide adequate temporal synchronization of the atrial and ventricular systoles, eliminating the resulting symptoms
Summary
Similar cycles presuppose the need to characterize the relationship of reciprocal interdependence of events in more extended monitoring.
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