Unusual pauses in sinus rhythm and intermittent 2 to 1 AV block in a patient with concealed his extra systoles--a rare cause of bradycardia.
A 56 year old male with a past medical history of hypertension and dyslipidemia presented with recurrent dizziness. Routine EKG was performed, which suggested frequent junctional extra systoles with compensatory pauses. During telemetry periods of 2:1 block with effective ventricular rate of 34 bpm was observed. His bundle study suggested frequent His extra systoles causing functional AV block. Treatment with anti-arrhythmic medication, paradoxically improved AV block and symptoms in our patient.
Mulpuru
Siva K
SK
Cardiovascular Diseases, Beth Israel Medical Center and Long Island College Hospital, Brooklyn, NY, USA. osmecan2000@yahoo.com
Diwan
Ravi
R
Manchego
Dayana Eslava
DE
Saponieri
Cesare
C
Vasavada
Balendu
B
His extra systoles; functional AV block