Retrograde Conduction in Complete Heart Block

Shim, Young-Hak; Lee, Woong-Ku; Cha, Hong-Do

doi:10.4070/kcj.1972.2.2.53

Korean Circ J. 1972 Dec;2(2):53-55. Korean.
Published online Dec 31, 1972.
https://doi.org/10.4070/kcj.1972.2.2.53

Case Report

Retrograde Conduction in Complete Heart Block

Young-Hak Shim, M.D., Woong-Ku Lee, M.D. and Hong-Do Cha, M.D.

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This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

A 45 year old man with a history of syncopal attacks of 3 days' duration showed complete heart block with occasional retrograde P waves following QRS complexes in the electrocardiogram.

The site of A-V block seemed to be below A-V node judging from the QRS complexes when occasional capture occured. This may be a case of complete heart block progressing from right bundle branch block plus left posterior hemiblock.

There was a rapid improvement of conduction with sublingual isoproterenol in a few days, EKG's showing normal A-V conduction and QRS complexes on discharge.

The mechanism of the retrograde conduction in the presence of complete heart block is discussed with a review of literature.