Key result
Minimal catheter manipulation during an electrophysiological study enabled the detection of a split His-electrogram in a patient with 2:1 AV block, highlighting the importance of catheter stability.
Case Report (n=1)
Catheter stability is crucial for precise recording of His potentials during electrophysiological studies to accurately diagnose intra-hisian AV block.
Emphasizes catheter stability for accurate His recordings in AV block; leaves open prospective validation in larger series.
Intra-hisian atrioventricular (AV) block is not a common phenomenon, but it is important for the development of advanced or complete AV block. We observed a 77-year-old female patient with the 2:1 AV block due to an intra-hisian block. In this case we tried to detect the block site, but an alternating pattern of the AH conduction was noted on the His-electrogram in the electrophysiological study (EPS). The cause of the confusing finding might have been the instability of the catheter to record a His potential. We could detect a splitting of the His-electrogram with an intra-hisian block after minimal manipulation of the catheter. The authors' observations suggest that catheter stability is important for a precise recording in the EPS and radiofrequency catheter ablation procedure.
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Seung Pyo Hong (2015) conducted a case report in 2:1 atrioventricular block due to intra-hisian block (n=1). Electrophysiological study and catheter manipulation was evaluated on Detection of the block site on His-electrogram. Minimal catheter manipulation during an electrophysiological study enabled the detection of a split His-electrogram in a patient with 2:1 AV block, highlighting the importance of catheter stability.
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