title: Alternating reversed wenckebach periodicity: Concealed electrotonic conduction as a possible mechanism.
abstract: Electrocardiograms were taken from a 67-year-old man with 2:1 atrioventricular block in whom alternating reversed Wenckebach periodicity was found. Long PR intervals of alternately conducted P waves progressively shortened until an alternate P wave was blocked. After an alternate P wave was blocked, the next alternate P wave was conducted to the ventricles with a markedly long PR interval. Then long PR intervals of alternately conducted P waves progressively shortened again until an alternate P wave was blocked. This is the first report on alternating reversed Wenckebach periodicity. It seems that concealed electrotonic conduction of alternately blocked impulses occurred as a possible mechanism.
authors.affiliation: Katoh Cardiovascular Clinic, Ohtsu; dagger School of Human Services, Hokkaidou Women's University, Ebetsu, Japan.
authors.forename: Takakazu
authors.initials: T
authors.lastname: Katoh
authors.forename: Shinji
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Tsujimura
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Sasaki
mesh_terms: D000368:Aged; D004562:Electrocardiography; D006327:Heart Block / Q000503:physiopathology*; D006801:Humans; D008297:Male