Key result
A transvenous pacing electrode exhibited an unusual exit block characterized by Wenckebach phenomenon, progressing from 1:1 pacing to 4:3 and 3:2 cycles, followed by a fixed 2:1 block.
This case report describes an unusual Wenckebach-type exit block from a transvenous pacing electrode in a patient with an acute inferior infarct.
Recognizing atypical Wenckebach exit block may aid device troubleshooting in acute MI; extends pacing phenomena descriptions but leaves open prevalence and mechanisms.
An unusual type of exist block from a transvenous pacing electrode was recorded in a 63-year-old man with an acute inferior infarct and cardiogenic shock. The pacemaker artefact to QRS interval increased gradually till there was loss of capture. A gradual change from I:I pacing rhythm to 4:3 and 3:2 Wenckebach cycles was recorded. This was followed by a fixed 2:I pacemaker artefact to QRS block.
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Harper et al. (1976) studied this question. A transvenous pacing electrode exhibited an unusual exit block characterized by Wenckebach phenomenon, progressing from 1:1 pacing to 4:3 and 3:2 cycles, followed by a fixed 2:1 block.
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