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Chest, Vol 73, 634-637, Copyright © 1978 by American College of Chest Physicians

ARTICLES

Dissociation of the atrioventricular node in acute inferior wall myocardial infarction. 1. Transverse dissociation (alternate Wenckebach periods)

S Sclarovsky, R Lewin, B Strasberg and J Agmon

Two cases of alternate Wenckebach periods developing during the acute phase of inferior wall myocardial infarction are presented. In both cases, syncope occurred and severe bradyarrhythmia was recorded on the day of admission. Electrophysiologic study performed in one patient and a narrow QRS complex in the other patient during the alternate Wenckebach periods confirmed the atrioventricular node as the level of block. Transverse dissociation of the atrioventricular node with two (or more) levels of block is the most acceptable explanation for this phenomenon. We suggest that alternate Wenckebach periods occurring during the acute phase of inferior wall myocardial infarction is a severe bradyarrhythmia, and prophylactic temporary pacing is recommended.




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Copyright © 1978 by the American College of Chest Physicians.