Weekly EP & ECG rounds at the BIDMC (Archive)
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Editors-In-Chief: Chris Pickett,M.D.; Peter Zimetbaum, M.D.; Mark Josephson, M.D.
August 2007
This patient is a 53 year old woman with a history of SVT who is referred for an electrophysiology study due dyspnea with exertion and a Holter ECG which showed several episodes of AV block second degree with 5:4, 4:3, and 3:2 conduction, as well as brief episodes of a junctional rhythm during the daytime. Prior to her EP study, she underwent stress testing and exercised 4 minutes on a BRUCE protocol, during whch she developed AV Wenckebach block and the test was stopped. She never has had an episode of syncope.
This is the baseline ECG:
Her baseline intracardiac recording shows:
This is her intracardiac recording with atrial pacing:
