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J Am Coll Cardiol, 1983; 2:578-581
© 1983 by the American College of Cardiology Foundation
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Exercise-induced distal atrioventricular block

AK Woelfel, RJ Simpson Jr, LS Gettes, and Foster JR

Three patients with 1:1 atrioventricular (AV) conduction at rest developed fixed 2:1 or 3:1 AV block during treadmill exercise testing. Electrophysiologic study documented block distal to the AV node in all three patients, and suggested that the exercise-induced block occurred because of increased atrial rate and abnormal refractoriness of the His-Purkinje conduction system. The findings in these three patients suggest that high grade AV block appearing during exercise reflects conduction disease of the His-Purkinje system rather than of the AV node, even in the absence of bundle branch block. Patients with this diagnosis should be considered for permanent cardiac pacing.


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Copyright © 1983 by the American College of Cardiology Foundation.