Exercise-induced complete heart block in a patient with chronic bifascicular block
Abstract
Heart block induced by exercise or associated with symptomatic, chronic bifascicular block can progress to high-grade atrioventricular (AV) block and sudden death. The authors describe a case of exercise-induced AV block in a patient with chronic bifascicular block. Thirty seconds of ventricular asystole were observed during exercise treadmill testing. Myocardial ischemia was ruled out, and the cause was determined to be distal AV nodal block. The pathophysiology, diagnosis, and treatment of distal AV nodal block are reviewed. The role of exercise treadmill testing and electrophysiologic studies in distal AV block are outlined in a diagnostic and therapeutic strategy.
Integrity signals
Registry
Cites
Statistics
Claims the paper makes
Claims other papers make about this one
Each is checked against this paper’s own text: does it say what the citing paper says it does?
Tachycardia-related exercise-induced second- and third-degree AV block predicts progression to permanent AV block.
“and predicts progression to permanent AV block. 254,255”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [254]
In tachycardia-related exercise-induced AV block, a resting ECG frequently shows intraventricular conduction abnormalities, but cases with a normal resting ECG have also been described.
“A resting ECG frequently shows intraventricular conduction abnormalities, 253,254 but cases with a normal resting ECG have also been described. 256,257”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [254]
Cites
Lasser, R. P., Haft, J. I., & Friedberg, C. K. (1968) · Circulation · doi:10.1161/01.cir.37.3.429 · Cited by 180 · see citing works
Dhingra, R. C., Wyndham, C. R. C., Bauernfeind, R. A., Swiryn, S., DEEDWANIA, P. C., Smith, T., DENES, P., & Rosen, K. M. (1979) · Circulation · doi:10.1161/01.cir.60.7.1455 · Cited by 160 · see citing works
Prognostic value of infranodal conduction time in patients with chronic bundle branch block.
Scheinman, M. M., Peters, R. W., Modin, G. W., Brennan, M., Mies, C., & O'Young, J. (1977) · Circulation · doi:10.1161/01.cir.56.2.240 · Cited by 140 · see citing works
Syncope in Patients with Chronic Bifascicular Block
Dhingra, R. C., DENES, P., Wu, D., Chuquimia, R., AMAT-Y-LEON, F., Wyndham, C. R. C., & ROSEN, K. M. (1974) · Annals of Internal Medicine · doi:10.7326/0003-4819-81-3-302 · Cited by 133 · see citing works
Exercise-induced distal atrioventricular block
Woelfel, A. K., Simpson, R. J., Gettes, L. S., & Foster, J. R. (1983) · Journal of the American College of Cardiology · doi:10.1016/s0735-1097(83)80288-5 · Cited by 106 · see citing works
Exercise-provoked distal atrioventricular block
Chokshi, S. K., Sarmiento, J., Nazari, J., Mattioni, T. A., Zheutlin, T. A., & Kehoe, R. (1990) · The American Journal of Cardiology · doi:10.1016/0002-9149(90)90749-q · Cited by 43 · see citing works
Significance of exercise-induced second degree atrioventricular block.
Bakst, A., Goldberg, B., & Schamroth, L. (1975) · Heart · doi:10.1136/hrt.37.9.984 · Cited by 39 · see citing works
Exercise-induced atrioventricular block: Report of three cases
Peller, O. G., Moses, J. W., & Kligfield, P. (1988) · American Heart Journal · doi:10.1016/0002-8703(88)90031-2 · Cited by 31 · see citing works
Freeman, G. L., Hwang, M. H., Danoviz, J., et al. (1984) · Journal of Electrocardiology · doi:10.1016/s0022-0736(84)80079-5 · Cited by 19 · see citing works
Atrioventricular block response to exercise and intraventricular conduction at rest.
Moulopoulos, S. D., Darsinos, J. T., & Sideris, D. A. (1972) · Heart · doi:10.1136/hrt.34.10.998 · Cited by 14 · see citing works
Tachycardia-dependent second degree AV-block in patient with right bundle branch block
Kalusche, D., & Roskamm, H. (1987) · Journal of Electrocardiology · doi:10.1016/s0022-0736(87)80107-3 · Cited by 9 · see citing works
Flagged first, then by citations
Cited by
Sorted by citations
2021 ESC Guidelines on cardiac pacing and cardiac resynchronization therapy
Glikson, M., Nielsen, J. C., Kronborg, M. B., Michowitz, Y., Auricchio, A., Barbash, I. M., Barrabés, J. A., Boriani, G., Braunschweig, F., Brignole, M., et al. (2021) · European Heart Journal · doi:10.1093/eurheartj/ehab364 · Cited by 2,019 · see citing works
2018 ESC Guidelines for the diagnosis and management of syncope
Brignole, M., Moya, A., de Lange, F. J., Deharo, J.-C., Elliott, P. M., Fanciulli, A., Fedorowski, A., Furlan, R., Kenny, R. A., Martín, A., et al. (2018) · European Heart Journal · doi:10.1093/eurheartj/ehy037 · Cited by 1,951 · see citing works
- Authors
- Byrne, J. M., Marais, H. J., & Cheek, G. A.
- Affiliations
- Loma Linda University (US)
- Corresponding author
- Byrne, John M.
- Venue
- Journal of Electrocardiology
- Publisher
- Elsevier BV
- Published
- 1994-10
- Volume
- 27
- Issue
- 4
- Pages
- 339-342
- ISSN
- 0022-0736 (ISSN-L)
- OpenAlex
- W2025709902
- Cited by
- 28
- References
- 11
- Citations by year
- 2026: 1 · 2024: 2 · 2022: 2 · 2021: 3 · 2020: 1 · 2019: 3 · 2018: 2 · 2013: 1
- FWCI
- 0.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Electrocardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac electrophysiology and arrhythmias
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac pacing and defibrillation studies
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiac Arrhythmias and Treatments
- Keywords
- complete heart block, bifascicular block, atrioventricular block, ventricular asystole, treadmill exercise testing, electrophysiological study, sudden cardiac death, pathophysiology
- MeSH terms
- Aged, Bundle-Branch Block, Chronic Disease, Electrocardiography, Exercise Test, Heart Arrest, Heart Block, Humans, Male, Syncope, Exercise, Exercise Tolerance
About these checks
Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
Statistics and arithmetic are recomputed, not judged.
Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.
What counts as a claim ›How we measure confidence ›How we check this ›
Are you an author, or do you see a problem with this page? Request a review
