Academic Journal
أعرض في EDS

Atypical Wenckebach AV Block in the Infra-Hisian Region: Clinical Implications and Management.

التفاصيل البيبلوغرافية
العنوان: Atypical Wenckebach AV Block in the Infra-Hisian Region: Clinical Implications and Management.
المؤلفون: Kaushik, Atul1, Jeewooth, Avinash2 avinashjeewooth@ymail.com, Jaswal, Aparna2, Chakravarty, Amitesh2, Bashir, Hamed2, Raina, Sukriti2
المصدر: American Journal of Case Reports. 12/20/2024, Vol. 25, p1-5. 5p.
مصطلحات موضوعية: *HIS bundle, *HEART block, *HEART diseases, *ARRHYTHMIA, *SYNCOPE
مستخلص: Background: Second-degree atrioventricular (AV) block is a frequently encountered conduction abnormality on surface electrocardiogram (ECG). However, it does not always imply a block at the AV nodal level. In rare cases, this block can occur below the bundle of His, within the infra-Hisian region of the His-Purkinje system. While the incidence of infra-Hisian block is generally low in the general population, it becomes more common in specific high-risk groups, such as older adults and individuals with structural heart disease. Infra-Hisian block carries a significant risk of progressing to complete heart block, particularly if the patient shows a markedly prolonged His-ventricular (HV) interval or evidence of a bi-fascicular block. Case Report: We present the case of a 65-year-old woman who experienced recurrent episodes of syncope. Her surface ECG revealed a bi-fascicular block along with Wenckebach AV block, and 24-h Holter monitoring showed no other significant abnormalities. A baseline short PR interval with second-degree AV block indicated a possible infranodal block. An electrophysiology study confirmed an atypical Wenckebach AV block with second-degree infra-Hisian AV block. The patient subsequently underwent permanent pacemaker implantation. Conclusions: Given its potential to develop into more severe forms of heart block, infra-Hisian block is a critical condition that requires accurate identification and management. Several ECG indicators can help diagnose second-degree AV block. For example, RP-dependent PR interval or RP-PR reciprocity is characteristic of Wenckebach AV block. A short PR interval at baseline and minimal amount of PR interval lengthening before block in type 1 second-degree AV block suggest involvement of the His-Purkinje system. [ABSTRACT FROM AUTHOR]
قاعدة البيانات: Academic Search Index
ResultId 1
Header asx
Academic Search Index
182235642
1452
6
Academic Journal
academicJournal
1451.86694335938
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&scope=site&db=asx&AN=182235642&custid=s6537998&authtype=sso
FullText Array ( [Availability] => 0 )
Array ( [0] => Array ( [Url] => https://resolver.ebscohost.com/openurl?custid=s6537998&groupid=main&authtype=ip,guest&sid=EBSCO:asx&genre=article&issn=19415923&ISBN=&volume=25&issue=&date=20241220&spage=1&pages=1-5&title=American Journal of Case Reports&atitle=Atypical%20Wenckebach%20AV%20Block%20in%20the%20Infra-Hisian%20Region%3A%20Clinical%20Implications%20and%20Management.&id=DOI:10.12659/AJCR.946186 [Name] => Full Text Finder (s6537998api) [Category] => fullText [Text] => Full Text Finder [Icon] => https://imageserver.ebscohost.com/branding/images/FTF.gif [MouseOverText] => Full Text Finder ) )
Items Array ( [Name] => Title [Label] => Title [Group] => Ti [Data] => Atypical Wenckebach AV Block in the Infra-Hisian Region: Clinical Implications and Management. )
Array ( [Name] => Author [Label] => Authors [Group] => Au [Data] => <searchLink fieldCode="AR" term="%22Kaushik%2C+Atul%22">Kaushik, Atul</searchLink><relatesTo>1</relatesTo><br /><searchLink fieldCode="AR" term="%22Jeewooth%2C+Avinash%22">Jeewooth, Avinash</searchLink><relatesTo>2</relatesTo><i> avinashjeewooth@ymail.com</i><br /><searchLink fieldCode="AR" term="%22Jaswal%2C+Aparna%22">Jaswal, Aparna</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Chakravarty%2C+Amitesh%22">Chakravarty, Amitesh</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Bashir%2C+Hamed%22">Bashir, Hamed</searchLink><relatesTo>2</relatesTo><br /><searchLink fieldCode="AR" term="%22Raina%2C+Sukriti%22">Raina, Sukriti</searchLink><relatesTo>2</relatesTo> )
Array ( [Name] => TitleSource [Label] => Source [Group] => Src [Data] => <searchLink fieldCode="JN" term="%22American+Journal+of+Case+Reports%22">American Journal of Case Reports</searchLink>. 12/20/2024, Vol. 25, p1-5. 5p. )
Array ( [Name] => Subject [Label] => Subject Terms [Group] => Su [Data] => *<searchLink fieldCode="DE" term="%22HIS+bundle%22">HIS bundle</searchLink><br />*<searchLink fieldCode="DE" term="%22HEART+block%22">HEART block</searchLink><br />*<searchLink fieldCode="DE" term="%22HEART+diseases%22">HEART diseases</searchLink><br />*<searchLink fieldCode="DE" term="%22ARRHYTHMIA%22">ARRHYTHMIA</searchLink><br />*<searchLink fieldCode="DE" term="%22SYNCOPE%22">SYNCOPE</searchLink> )
Array ( [Name] => Abstract [Label] => Abstract [Group] => Ab [Data] => Background: Second-degree atrioventricular (AV) block is a frequently encountered conduction abnormality on surface electrocardiogram (ECG). However, it does not always imply a block at the AV nodal level. In rare cases, this block can occur below the bundle of His, within the infra-Hisian region of the His-Purkinje system. While the incidence of infra-Hisian block is generally low in the general population, it becomes more common in specific high-risk groups, such as older adults and individuals with structural heart disease. Infra-Hisian block carries a significant risk of progressing to complete heart block, particularly if the patient shows a markedly prolonged His-ventricular (HV) interval or evidence of a bi-fascicular block. Case Report: We present the case of a 65-year-old woman who experienced recurrent episodes of syncope. Her surface ECG revealed a bi-fascicular block along with Wenckebach AV block, and 24-h Holter monitoring showed no other significant abnormalities. A baseline short PR interval with second-degree AV block indicated a possible infranodal block. An electrophysiology study confirmed an atypical Wenckebach AV block with second-degree infra-Hisian AV block. The patient subsequently underwent permanent pacemaker implantation. Conclusions: Given its potential to develop into more severe forms of heart block, infra-Hisian block is a critical condition that requires accurate identification and management. Several ECG indicators can help diagnose second-degree AV block. For example, RP-dependent PR interval or RP-PR reciprocity is characteristic of Wenckebach AV block. A short PR interval at baseline and minimal amount of PR interval lengthening before block in type 1 second-degree AV block suggest involvement of the His-Purkinje system. [ABSTRACT FROM AUTHOR] )
RecordInfo Array ( [BibEntity] => Array ( [Identifiers] => Array ( [0] => Array ( [Type] => doi [Value] => 10.12659/AJCR.946186 ) ) [Languages] => Array ( [0] => Array ( [Code] => eng [Text] => English ) ) [PhysicalDescription] => Array ( [Pagination] => Array ( [PageCount] => 5 [StartPage] => 1 ) ) [Subjects] => Array ( [0] => Array ( [SubjectFull] => HIS bundle [Type] => general ) [1] => Array ( [SubjectFull] => HEART block [Type] => general ) [2] => Array ( [SubjectFull] => HEART diseases [Type] => general ) [3] => Array ( [SubjectFull] => ARRHYTHMIA [Type] => general ) [4] => Array ( [SubjectFull] => SYNCOPE [Type] => general ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => Atypical Wenckebach AV Block in the Infra-Hisian Region: Clinical Implications and Management. [Type] => main ) ) ) [BibRelationships] => Array ( [HasContributorRelationships] => Array ( [0] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Kaushik, Atul ) ) ) [1] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Jeewooth, Avinash ) ) ) [2] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Jaswal, Aparna ) ) ) [3] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Chakravarty, Amitesh ) ) ) [4] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Bashir, Hamed ) ) ) [5] => Array ( [PersonEntity] => Array ( [Name] => Array ( [NameFull] => Raina, Sukriti ) ) ) ) [IsPartOfRelationships] => Array ( [0] => Array ( [BibEntity] => Array ( [Dates] => Array ( [0] => Array ( [D] => 20 [M] => 12 [Text] => 12/20/2024 [Type] => published [Y] => 2024 ) ) [Identifiers] => Array ( [0] => Array ( [Type] => issn-print [Value] => 19415923 ) ) [Numbering] => Array ( [0] => Array ( [Type] => volume [Value] => 25 ) ) [Titles] => Array ( [0] => Array ( [TitleFull] => American Journal of Case Reports [Type] => main ) ) ) ) ) ) )
IllustrationInfo