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KMID : 1011920100110010043
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International Journal of Arrhythmia
2010 Volume.11 No. 1 p.43 ~ p.46
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A case of infra His 2:1 atrioventricular block with narrow QRS complex
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Lee Young-Soo
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Abstract
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2:1 atrioventricular (AV) block can occur in either the AV node or the His-Purkinje system and cannot be classified into type I or type II second-degree AV block because there is only one PR interval to examine before the blocked P wave. Type I and type II second-degree AV block can progress to 2:1 AV block, and 2:1 AV block can regress to type I or type II block. Consequently, the site of the lesion in 2:1 block can often be determined by seeking the company 2:1 AV block keeps. An association with type I block and a narrow QRS complex almost always reflects AV nodal block but type I block with a wide QRS complex occurs more commonly in the His-Purkinje system than the AV node. Type II block, if correctly defined, is infra-nodal block. Outside of acute myocardial infarction, sustained 2:1 and 3:1 AV block with a wide QRS complex occurs in the His-Purkinje system in 80% of cases and 20% in the AV node. Administration of atropine or exercise in patients with His-Purkinje disease may increase the degree of AV block.
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KEYWORD
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atrioventricular block
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