Published online Oct 26, 2015. doi: 10.4330/wjc.v7.i10.700
Peer-review started: February 22, 2015
First decision: April 10, 2015
Revised: June 7, 2015
Accepted: July 16, 2015
Article in press: July 17, 2015
Published online: October 26, 2015
Intra-hisian atrioventricular (AV) block is not a common phenomenon, but it is important for the development of advanced or complete AV block. We observed a 77-year-old female patient with the 2:1 AV block due to an intra-hisian block. In this case we tried to detect the block site, but an alternating pattern of the AH conduction was noted on the His-electrogram in the electrophysiological study (EPS). The cause of the confusing finding might have been the instability of the catheter to record a His potential. We could detect a splitting of the His-electrogram with an intra-hisian block after minimal manipulation of the catheter. The authors’ observations suggest that catheter stability is important for a precise recording in the EPS and radiofrequency catheter ablation procedure.
Core tip: Intra-hisian atrioventricular (AV) block associated with 2:1 AV block is an uncommon phenomenon, but it is important for the development of complete AV block. We observed a 77-year-old female with 2:1 AV block due to an intra-hisian block. An alternating pattern of the AH conduction was noted on the His-electrogram. The cause of that confusing finding might have been the instability of the catheter for recording the His potential. We could detect a splitting of the His-electrogram with intra-hisian block after minimal manipulation of the catheter. The authors’ observations suggest that catheter stability is important for a precise recording.