Prolonged ventricular pauses in an asymptomatic athlete with "apparent Mobitz type II second-degree atrioventricular block".
We report the case of a 30-year-old basketball player with asymptomatic, nocturnal ventricular pauses of >3,000 ms, the longest being ∼12,000 ms, who was misdiagnosed with Mobitz type II second-degree atrioventricular (AV) block. Conversely, the tracings were characteristic of a vagally mediated AV block, a phenomenon first described by Massie and called "apparent Mobitz type II AV block." Although the patient was asymptomatic with ventricular pauses occurring only at night, it was decided to implant a permanent pacemaker to prevent neurological damage or life-threatening ventricular arrhythmias resulting from repeated, abnormally prolonged ventricular pauses. The persistence of AV block after a 3-month detraining period led us to believe that our decision was reasonable.
Division of Cardiology, San Giuseppe Moscati Hospital, Avellino, Italy. francesco.rotondi@tin.it
Francesco
F
Rotondi
Luciano
L
Marino
Tonino
T
Lanzillo
Fiore
F
Manganelli
Paolo
P
Zeppilli
D000328:Adult; D054537:Atrioventricular Block / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D001490:Basketball; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D017180:Tachycardia, Ventricular / Q000150:complications / Q000175:diagnosis* / Q000517:prevention & control*; D016896:Treatment Outcome