Abstract
Paroxysmal atrioventricular (AV) block is characterized by sudden appearance of complete heart block with no escape rhythm. Three types have been described having different mechanisms namely, vagally mediated, intrinsic, and idiopathic. A rare case scenario is being described with the occurrence of paroxysmal AV block of all three types in the same patient.
Highlights
Raghav Bansal MD, DM1 | Ankit Mahajan MD, DM1 | Chetan Rathi MD, DNB1 | Akshay Mehta MD, DM2 | Yash Lokhandwala MD, DM, FACC3
Resumption of normal AV conduction is accompanied by gradual restoration of sinus rate
Phase 4 aberrancy or block occurs when the supraventricular impulse is unable to conduct in the diseased His‐Purkinje system (HPS).[5]
Summary
Raghav Bansal MD, DM1 | Ankit Mahajan MD, DM1 | Chetan Rathi MD, DNB1 | Akshay Mehta MD, DM2 | Yash Lokhandwala MD, DM, FACC3. Paroxysmal atrioventricular (AV) block is an uncommon cause of syncope which can often be missed or overlooked because of its unfamiliarity, unpredictability, and frequent absence of cardiac and resting ECG abnormalities especially with no clear evidence of AV conduction disease. Carotid sinus massage triggered a paroxysmal AV block with slowing of sinus rate, associated with near‐syncope (Figure 1).
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