Why the study?
Does ventricular pacing affect AV conduction in a patient with Mobitz II AV block and bifascicular block?
Does ventricular pacing affect AV conduction in a patient with Mobitz II AV block and bifascicular block?
Ventricular pacing can induce temporary depression of distal AV conduction in patients with pre-existing conduction system disease.
May warrant caution with prolonged or rapid ventricular pacing in bifascicular block; leaves open generalizability from this single case.
A 61-year-old man presented with symptomatic 2 degree Mobitz II AV block in association with bifascicular block. Ventricular pacing resulted in temporary depression of AV conduction. The extent of pacing-induced AV block varied directly with the duration and rate of ventricular pacing. Intracardiac recordings proved that the site of spontaneous and pacing-induced AV block was distal to the His bundle. Possible mechanisms by which this phenomenon may arise and several implications of practical importance are discussed.
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Wald et al. (1981) studied this question.
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