QRS alternans with 2:1 atrioventricular conduction block: What is the mechanism?

Takumi Yamada, Paul B. Tabereaux, H. Thomas McElderry, G. Neal Kay

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

An 81-year-old woman was admitted for symptomatic bradycardia. On admission, the ECG exhibited QRS alternans, narrow QRS complex and left bundle branch block with 2:1 AV block. The patient soon had complete AV block and underwent a pacemaker implantation. An appropriate mechanism for explaining those ECG findings might be 4:1 conduction over the left bundle branch and 2:1 conduction over the right bundle branch. An ECG pattern exhibiting QRS alternans with a narrow QRS complex and bundle branch block with 2:1 AV block may suggest the coexistence of both bundle branch blocks and a high risk of complete AV block.

Original languageEnglish (US)
Pages (from-to)314-316
Number of pages3
JournalAnnals of Noninvasive Electrocardiology
Volume13
Issue number3
DOIs
StatePublished - Jul 2008
Externally publishedYes

Keywords

  • Atrioventricular conduction block
  • Bundle branch block
  • QRS alternans

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