title: Wenckebach's periods or alternating Wenckebach's periods during 4:1 atrioventricular block?
abstract: This article deals with the tracings of a patient having episodes of atrial flutter with 4:1 atrioventricular (AV) block increasing to 8:1 AV block. This phenomenon was attributed to the coexistence of 3-level block due to transverse dissociation with 2:1 AV block in the most proximal level, or first level as well as in the second level coexisting with a Wenckebach's period in the most distal, or third level. It is suggested that perhaps the term Wenckebach's periods during progression of 4:1 AV block best describes this arrhythmia so as to maintain the term alternating Wenckebach's periods only to those occurring when 2:1 block increases to higher degrees of AV block.
authors.affiliation: Division of Cardiology, University of Miami School of Medicine, Miami, FL 33101, USA. a.castellanos@miami.edu
authors.forename: Agustin
authors.initials: A
authors.lastname: Castellanos
authors.forename: Jorge
authors.initials: J
authors.lastname: Diaz
authors.forename: Alberto
authors.initials: A
authors.lastname: Interian
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Myerburg
mesh_terms: D000368:Aged; D001282:Atrial Flutter / Q000503:physiopathology*; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000503:physiopathology*; D006801:Humans