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Exercise-induced distal atrioventricular block
Open accessAbstract
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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“Tachycardia-related exerciseinduced second- and third-degree AV block has been shown to be located distal to the AV node 253”
From 2018 ESC Guidelines for the diagnosis and management of syncope (2018) · cites this paper as [253]
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“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 [253]
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Metadata
- Authors
- Woelfel, A. K., Simpson, R. J., Gettes, L. S., & Foster, J. R.
- Affiliations
- University of North Carolina at Chapel Hill (US)
- Corresponding author
- Foster, James R.
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 1983-09
- Volume
- 2
- Issue
- 3
- Pages
- 578-581
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2076374966
- Cited by
- 106
- References
- 18
- Citations by year
- 2026: 2 · 2024: 4 · 2023: 3 · 2022: 4 · 2021: 4 · 2020: 3 · 2019: 10 · 2018: 8 · 2017: 9 · 2016: 1 · 2015: 2 · 2014: 3 · 2013: 4 · 2012: 1
- FWCI
- 0.73
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Carolina Digital Repository (University of North Carolina at Chapel Hill) (submittedVersion)
- UNC Libraries
- Funders
- National Institutes of Health
- 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
- high-grade atrioventricular block, His-Purkinje system, cardiac conduction disorders, atrial rate, refractoriness, treadmill exercise testing, permanent cardiac pacing, bundle branch block
- MeSH terms
- Aged, Atrioventricular Node, Electrocardiography, Electrophysiology, Physical Exertion, Heart Block, Heart Conduction System, Humans, Male, Middle Aged
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