Double Wenckebach phenomenon in atrioventricular node and His bundle. Electrophysiological demonstration in a case of atrial flutter.
In a case of atrial flutter with a 9:2 atrioventricular response, the only possible way to explain the conduction pattern was 3:1 block in the atrioventicular node (which is 3:2 Wenckebach sequence in the N zone and a 2:1 block at the junction of the node with the bundle of His) plus 3:2 Wenckebach sequence distal to the H deflection. The recording of the His bundle deflection confirmed this analysis.
D000368:Aged; D001282:Atrial Flutter / Q000503:physiopathology*; D001283:Atrioventricular Node / Q000503:physiopathology*; D002036:Bundle of His / Q000503:physiopathology; D004562:Electrocardiography; D006329:Heart Conduction System / Q000503:physiopathology*; D006801:Humans; D008297:Male