[Pseudo AV dissociation caused by interpolated junctional extrasystoles in the presence of a first-degree AV block].
This presentation reports an electrocardiogram showing first degree A-V block with a very prolonged P-R interval of 0.80 sec. On several occasions an arrhythmia occurred, characterized by what looked like an A-V junctional escape rhythm with A-V dissociation. This was suggested by a variable and, at first glance, haphazard relationship between QRS complexes and P waves. Analysis of the tracing suggested that the pattern was due to an interpolated A-V junctional extrasystole, followed by a sinus beat with an inordinately long P-R interval, whose duration was 1.18 sec. This very prolonged A-V conduction time made it difficult to recognize the relationship between P waves and QRS complexes, so that the pattern appeared as an A-V dissociation.
Scimone
I M
IM
Casa di Cura Policlinico Madonna della Consolazione, Divisione di Cardiologia, Reggio Calabria.
Oreto
G
G
Consolo
A
A
Pulitanò
G
G
D000368:Aged; D000889:Anti-Arrhythmia Agents / Q000008:administration & dosage; D001281:Atrial Fibrillation / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy / Q000503:physiopathology; D001283:Atrioventricular Node / Q000187:drug effects / Q000503:physiopathology*; D005117:Cardiac Complexes, Premature / Q000175:diagnosis / Q000209:etiology / Q000503:physiopathology*; D004359:Drug Therapy, Combination; D004562:Electrocardiography / Q000187:drug effects / Q000706:statistics & numerical data; D005260:Female; D006327:Heart Block / Q000150:complications / Q000175:diagnosis / Q000503:physiopathology*; D006801:Humans; D011802:Quinidine / Q000008:administration & dosage / Q000031:analogs & derivatives; D013997:Time Factors; D014700:Verapamil / Q000008:administration & dosage
D000889:Anti-Arrhythmia Agents; C014486:hydroquinidine; D014700:Verapamil; D011802:Quinidine