Japanese Journal of Electrocardiology
Online ISSN : 1884-2437
Print ISSN : 0285-1660
ISSN-L : 0285-1660
A Case of Pause-Dependent Paroxysmal Atrio-Ventricular Block in a Structurally Normal Heart Requiring Permanent Pacemaker Implantation
Mieko Tamura, Makoto Noda, Tasuku Murakami, Shingo Watanabe, Akiko Ooyama, Yasuhito Yamamoto, Hironori Tashiro, Michio Usui, Kenichiro Ichikawa, Koso Egi, Akifusa Hariya, Kenji Takazawa, Mitsuaki Isobe
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Keywords: HV block, Pacemaker implantation, Phase-4 block
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2012 Volume 32 Issue 1 Pages 5-10

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Abstract
A 47-year-old male was admitted to our hospital because of faintness on complete atrio-ventricular block. Ultrasound echocardiogram and coronary angiogram showed structurally normal. Electrophysiological test showed persistent HV block with a QRS rate of 37 beats per minute. However, continuous atrio-ventricular conduction was observed during 20bpm rapid atrial pacing with a rate of 110 beats per minute repeatedly. Spontaneous atrio-ventricular block was also documented in slow sinus rate on remarkable sinus arrhythmia. A dual chamber pacemaker was implanted. The mechanism responsible for the appearance of pause-dependent block in a patient with a structurally normal heart is unknown, but may be related to a phase-4 block.
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© 2012 Japanese　Heart　Rhythm　 Society
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