Heart Blocks

  • J. Anthony GomesEmail author


In this chapter the author discusses the different types of heart blocks and their causes, presentation, and evaluation, the bifascicular and the trifascicular concept of Mauricio Rosenbaum, the HV interval in bifascicular blocks and its significance, bundle branch blocks due to longitudinal dissociation, trans-aortic valve replacement-related AV block, and, finally, the treatment of heart blocks.


AV block Wenckebach block Mobitz type I AV block Mobitz type II AV block Bifascicular blocks Intrahisian block Paroxysmal AV block Longitudinal dissociation 


  1. 1.
  2. 2.
    Silverman ME, Upshaw CB Jr. Walter Gaskell and the understanding of atrioventricular conduction and block. J Am Coll Cardiol. 2002;39(10):1574–80.PubMedGoogle Scholar
  3. 3.
    Silverman ME, Upshaw CB Jr, Lange HW. Woldemar Mobitz and his 1924 classification of second-degree atrioventricular block. Circulation. 2004;110:1162–7.PubMedGoogle Scholar
  4. 4.
    Wenckebach KF. Die Unregelmassige Hertztatigkeit (Arythmia of the heart), trans. Thomas Snowball. Edinburgh and London: William Green & Sons; 1904.Google Scholar
  5. 5.
    Pérez-Riera AR, Femenía F, McIntyre WF, Baranchuk A. Karel Frederick Wenckebach (1864–1940): a giant of medicine. Cardiol J. 2011;18(3):337–9.PubMedGoogle Scholar
  6. 6.
    Mobitz W. Über die unvollständige Störung der Erregungsüberleitung zwischen Vorhof und Kammer des menschlichen Herzens [On the partial block of impulse conduction between atrium and ventricle of human hearts]. Z Gesamte Exp Med. 1924;41:180–237.Google Scholar
  7. 7.
    Katz LN, Pick A. Clinical electrocardiography. Part I. The arrhythmias. Philadelphia: Lea and Febiger; 1956.Google Scholar
  8. 8.
    Pick A, Langendorf R. Interpretation of complex arrhythmias, vol. 241. Philadelphia: Lea and Febiger; 1979.Google Scholar
  9. 9.
    Castellanos A, Moleiro F. The Chicago school of arrhythmology: an analysis of a revisionist view. PACE. 2001;24:135–7.PubMedGoogle Scholar
  10. 10.
    Barold SS. The Chicago school of electrocardiography and second-degree atrioventricular block: an historical perspective. PACE. 2001;24:138–46.PubMedGoogle Scholar
  11. 11.
    Dreifus LS. “The Chicago School”: Drs. LN Katz, A Pick and R Langendorf. ACC Curr J Rev. 2000:17–22.Google Scholar
  12. 12.
    Rosenbaum MB, Elizari MV, Lázzari JO. Los Hemibloqueos. Editorial Paidós: Buenos Aires; 1968.Google Scholar
  13. 13.
    Rosenbaum MB, Elizari MV, Lazzari JO. The Hemiblocks. Tampa: Tracings; 1970.Google Scholar
  14. 14.
    Elizari MV, Rosenbaum MB. A revolutionary electrocardiologist from the southern hemisphere, 1921-2003. Circulation. 2003;108:780–1.Google Scholar
  15. 15.
    Scherlag BJ, Lau SH, Helfant RH, et al. Catheter technique for recording His Bundle’ activity in man. Circulation. 1969;39:13–8.PubMedGoogle Scholar
  16. 16.
    Durrer D, Schoo L, Schuilenberg RM, et al. The role of premature beats in the initiation and termination of supraventricular tachycardia in the Wolff-Parkinson- White syndrome. Circulation. 1967;36:644–62.PubMedGoogle Scholar
  17. 17.
    Coumel PL, Cabral C, Fabiato A, et al. Tachycardia permanente par rhythm reciproque. Arch Mal Coeur. 1967;60:1830.Google Scholar
  18. 18.
    Damato AN, et al. Study of atrioventricular conduction in man using electrode catheter recordings of His bundle activity. Circulation. 1969;39:287–96.PubMedGoogle Scholar
  19. 19.
    Damato AN, et al. A study of heart block in man using His bundle recordings. Circulation. 1969;39:297–305.PubMedGoogle Scholar
  20. 20.
    Damato AN, Lau SH. Clinical value of the electrogram of the conducting system. Prog Cardiovasc Dis. 1970;13:119.PubMedGoogle Scholar
  21. 21.
    Lau SH, Damato AN. Mechanism of AV blocks. Cardiovasc Clin. 1970;2:50.Google Scholar
  22. 22.
    Narula OS, et al. Analysis of A-V conduction defect in complete heart block utilizing His bundle electrograms. Circulation. 1970;41:437–48.PubMedGoogle Scholar
  23. 23.
    Narula OS, Samet P. Wenckebach and Mobitz II A-V block due to block within the His bundle and bundle branches. Circulation. 1970;41:947–65.PubMedGoogle Scholar
  24. 24.
    Puech P, et al. Leurigistrement de l’ activiteelectrique du fasciau de His dans les blocks AV spontantanes. Arch Mal Coeur. 1970;63:784.PubMedGoogle Scholar
  25. 25.
    Rosen KM, et al. Site of block in acute myocardial infarction. Circulation. 1970;42:925–33.PubMedGoogle Scholar
  26. 26.
    Damato AN, et al. Use of His bundle recordings in diagnosing conduction disturbances. Bull N Y Acad Med. 1971;47:905.PubMedPubMedCentralGoogle Scholar
  27. 27.
    Haft JI, Weinstock M, De Guia R. Electrophysiologic studies in Mobitz type II second degree heart block. Am J Cardiol. 1971;27:682–8.PubMedGoogle Scholar
  28. 28.
    Rosen KM, et al. Electrophysiologic significance of first-degree atrioventricular block with intraventricular conduction disturbance. Circulation. 1971;43(4):491–502.PubMedGoogle Scholar
  29. 29.
    Steiner C, Lau SH, Stein E, et al. Electrophysiologic documentation of trifascicular block as a common cause of complete heart block. Am J Cariol. 1971;28(4):436–41.Google Scholar
  30. 30.
    Schuillenberg RM, Durrer D. Conduction disturbances located within the His bundle. Circulation. 1972;45:612–28.Google Scholar
  31. 31.
    Damato AN, Gallagher JJ, Lau SH. Application of His bundle recordings in diagnosing conduction disorders. Prog Cardiovsc Dis. 1972;14(6):601–20.Google Scholar
  32. 32.
    Kelly DT, Brodsky SJ, Mirowski M, Krovetz LJ, Rowe RD. Bundle of His recordings in congenital complete heart block. Circulation. 1972;46:277–81.Google Scholar
  33. 33.
    Berkowitz WD, Lau SH, Patton RD, Rosen KM, Damato AN. The use of His bundle recordings in the analysis of unilateral and bilateral bundle branch block. Am Heart J. 1971;81:340–50.PubMedGoogle Scholar
  34. 34.
    Hecht HH, Kossmann CE, Childers RW, et al. Atrioventricular and intraventricular conduction. Revised nomenclature and concepts. Am J Cardiol. 1973;31:232–44.PubMedGoogle Scholar
  35. 35.
    Dhingra RC, Denes P, Delon WU, Chuquimia R, Rosen KM. The significance of second degree AV block and bundle branch block. Circulation. 1974;49:638–46.PubMedGoogle Scholar
  36. 36.
    Haft JI, Weinstock M, DeGuia R, Gupta PK, Fano A. Assessment of atrioventricular conduction in left and right bundle branch block using His bundle electrograms and atrial pacing. Am J Cardiol. 1971;27(5):474–80.PubMedGoogle Scholar
  37. 37.
    Gomes JAC, Damato AN. His bundle electrocardiograph and intracardiac stimulation in the evaluation of patients with atrioventricular conduction defects and sick sinus syndrome. In: Varialle P, editor. Cardiac pacing: Lea and Febiger; 1979. p. 97–122.Google Scholar
  38. 38.
    Gomes JAC, El-Sherif N. His bundle recordings: contributions to clinical electrophysiology. In: Samet P, El-Sherif N, editors. Cardiac pacing: Grune and Stratton; 1979. p. 375–407.Google Scholar
  39. 39.
    Gomes JAC, El-Sherif N. Atrioventricular block: mechanism, clinical presentation and therapy. Med Clin North Am Cardiac Arrhythmias I. 1984:955–67.Google Scholar
  40. 40.
    Katz LN, Pick A. Clinical electrocardiography. In: The arrhythmias. Philadelphia: Lea & Febiger; 1956.Google Scholar
  41. 41.
    Levites R, Haft JI. Significance of first degree heart block (prolonged P-R interval) in bifascicular block. Am J Cardiol. 1974;34(3):259–64.PubMedGoogle Scholar
  42. 42.
    Upshaw CB Jr, Silverman ME. Luigi Luciani and the earliest graphic demonstration of Wenckebach periodicity. Circulation. 2000 Jun 6;101(22):2662–8.PubMedGoogle Scholar
  43. 43.
    Friedman HS, Gomes JAC, Haft JI. An analysis of Wenckebach periodicity. J Electrocardiol. 1976;4:307–15.Google Scholar
  44. 44.
    Hoffman BF, Cranefield PF. Electro- physiology of the heart. New York: McGraw-Hill; 1960.Google Scholar
  45. 45.
    Cranefield PF, Hoffman BF, de Carvalho AP. Effects of acetylcholine on single fibers of the atrioventricular node. Circ Res. 1959;7:I9–23.Google Scholar
  46. 46.
    Cranefield PF, Klein HO, Hoffman BF. Conduction of the cardiac impulse. I. Delay, block, and one way block in depressed Purkinje fibers. Circ Res. 1971;28:199–219.PubMedGoogle Scholar
  47. 47.
    Watanabe Y, Dreifus LS. Second degree atrioventricular block. Cardiovasc Res. 1967;1:I50–158.Google Scholar
  48. 48.
    Loheetha Ragupathi MD, Drew Johnson MD, Arnold Greenspon MD, et al. Clinical and electrophysiological characteristics of patients with paroxysmal intra-His block with narrow QRS complexes. Heart Rhythm. 2018;15:1372–7.PubMedGoogle Scholar
  49. 49.
    Scheiman MM. Progression of intrahisian atrioventricular block: will this presage a renaissance of His-bundle studies. Heart Rhythm. 2018;15:1378.Google Scholar
  50. 50.
    Brignole M, Sutton R, Menozzi C, et al. Lack of correlation between the responses to tilt testing and adenosine triphosphate test and the mechanism of spontaneous neurally mediated syncope. Eur Heart J. 2006;27:2232–9.PubMedGoogle Scholar
  51. 51.
    Aste M, Brinole M. Syncope and paroxysmal atrioventricular block. J Arrhythm. 2017;33:562–7.PubMedPubMedCentralGoogle Scholar
  52. 52.
    O’Brien ET. Dublin masters of clinical expression II: Robert Adams (1791-1875). J Ir Coll Phys Surg. 1974;3(4):127.Google Scholar
  53. 53.
    Cantwell JD. Profiles in cardiology: William Stokes (1804-1878). Clin Cardiol. 1988;11(2):856–8.PubMedGoogle Scholar
  54. 54.
    Sebastian AA. A dictionary of the history of medicine, vol. 10965. Pearl River: Pantheon Publishing Group Inc.; 1999.Google Scholar
  55. 55.
    Chopra HK, Nanda NC, editors. Textbook of cardiology: a clinical and historical perspective. Chapter 47: a history of syncope. New Delhi, Panama City, London, Dhaka, Kathmar: Jaypee Brothers Medical Publishers; 2013.Google Scholar
  56. 56.
    Porzionato A, Macchi V, Stecco C, et al. The Anatomical School of Padua. Anat Rec. 2012;295(6):902–16.Google Scholar
  57. 57.
    Wilson FN, Johnston FD, Barker PS. Electrocardiogram of an unusual type in right bundle branch block. Amer Heart J. 1934;9:472.Google Scholar
  58. 58.
    Grant RP. Left axis deviation: an electrocardiographic pathologic correlation. Circulation. 1956;14:233.PubMedGoogle Scholar
  59. 59.
    de Luna AB. Dr. Mauricio Rosenbaum. In: Memorium, vol. 6: Revista Espanola de Cardiologia; 2017. p. 166.Google Scholar
  60. 60.
    Tawara S. Das Reizleitungssystem des Saeugetierherzens Eine anatomisch-histologische Studie uber das Atrioventrikularbundel und die Purkinjeschen Faden. Jena: Verslag Gustav Fischer; 1906. p. 35–201.Google Scholar
  61. 61.
    Tawara S. Die topographie und histologie der bruckenfaser: ein beitrag zur lehre vonder bedeutung der Purkinjeschen faden. Zantralbl Physiol. 1906;19:70–9.Google Scholar
  62. 62.
    Suma K. Sunao Tawara: a father of modern cardiology. Pacing Clin Electrophysiol. 2001;24:88–96.PubMedGoogle Scholar
  63. 63.
    Uhley HN, Rivkin L. Peripheral distribution of the canine A-V conduction system. Am J Cardiol. 1960;5:688–91.PubMedGoogle Scholar
  64. 64.
    Uhley HN, Rivkin LM. Electrocardiographic patterns following interruption of the main and peripheral branches of the canine left bundle of His. Am J Cardiol. 1964;13:41–7.PubMedGoogle Scholar
  65. 65.
    Robb JS. Comparative basic cardiology. New York: Grune & Stratton; 2002.Google Scholar
  66. 66.
    Durrer D, Van Dam RT, Freud GE, et al. Total excitation of the isolated human heart. Circulation. 1970;44:899–912.Google Scholar
  67. 67.
    Rossi L. Trifascicular conduction system and left branch hemiblock. Anatomical and histopathological considerations. G Ital Cardiol. 1971;1:55–62.PubMedGoogle Scholar
  68. 68.
    Demoulin JC, Kulbertus HE. Histopathological examination of concept of left hemiblock. Br Heart J. 1972;34:807–14.PubMedPubMedCentralGoogle Scholar
  69. 69.
    Demoulin JC, Kulbertus HE. Left hemiblocks revisited from the histopathological view point. Am Heart J. 1973;86:712–3.PubMedGoogle Scholar
  70. 70.
    Uhley HN. Some controversy regarding the peripheral distribution of the conduction system. Am J Cardiol. 1972;30:919–20.PubMedGoogle Scholar
  71. 71.
    Myerburg RJ, Nilsson K, Gelband H. Physiology of canine intraventricular conduction and endocardial excitation. Circ Res. 1972;30:217–43.PubMedGoogle Scholar
  72. 72.
    Myerburg RJ, Castellanos A, Basset A, et al. Functional properties of the distal AV conducting system. Adv Cardiol. 1975;14:94–104.PubMedGoogle Scholar
  73. 73.
    Lazzara R, Yeh BK, Samet P. Functional anatomy of the canine left bundle branch. Am J Cardiol. 1974;33:623–32.PubMedGoogle Scholar
  74. 74.
    Lasser RP, Haft JI, Friedberg CK. Re1ationship of right bundle branch block and marked left axis duration (with left parietal peri-infarction block) to complete heart block and syncope. Circulation. 1968;37:429–37.PubMedGoogle Scholar
  75. 75.
    Lie KI, Wellens HJ, Schuilenberg RM. Bundle branch block and acute myocardial infarction. In: Wellens HJJ, Lie KI, Janse MJ, editors. The conducting system of the heart: structure, function, and clinical implications. Philadelphia: Lea & Febiger; 1976. p. 662–72.Google Scholar
  76. 76.
    Hindman MC, Wagner GS, JaRo M, et al. The clinical significance of bundle branch block complicating acute myocardial infarction 1: clinical characteristics; hospital mortality and one year follow-up. Circulation. 1978;58:679–88.PubMedGoogle Scholar
  77. 77.
    Rotman M, Yriebwasser JH. A clinical and follow-up study of right and left bundle branch block. Circulation. 1975;51(3):477–84.PubMedGoogle Scholar
  78. 78.
    Dhingra RC, Amat-Y-Leon F, Wyndham C, et al. Significance of left axis deviation in patients with chronic left bundle branch block. Am J Cardiol. 1978;42:551–6.PubMedGoogle Scholar
  79. 79.
    Castellanos A Jr, Maytin O, Arcebal AG, et al. Significance of complete right bundle branch block with right axis deviation in absence of right ventricular hypertrophy. Br Heart J. 1970;32(1):85–92.PubMedPubMedCentralGoogle Scholar
  80. 80.
    Ragnathan N, Durandhar R, Phillips JH, Wigle ED, et al. His bundle electrogram in bundle branch block. Circulation. 1972;44:282–94.Google Scholar
  81. 81.
    Denes P, Dhingra RC, Chuquimia R, et al. H-V interval in patients with bifascicular block (right bundle branch block and left anterior hemiblock). Clinical, electrocardiographic and electrophysiologic correlation. Am J Cardio. 1975;I35:23–9.Google Scholar
  82. 82.
    Narula OS, Gann D, Samet P. Prognostic value of HV intervals, in His bundle electrocardiography and clinical electrophysiology. Philadelphia: FA Davis; 1975. p. 43.Google Scholar
  83. 83.
    Scheinman MM, Peters RW, Modin G, et al. Prognostic value of infranodal conduction time in patients with chronic bundle branch block. Circulation. 1977;56:240–4.PubMedGoogle Scholar
  84. 84.
    Dhingra RC, Denes P, Wu D, et al. Prospective observations in patients with chronic bundle branch block and marked HV prolongation. Circulation. 1976;53:600–4.PubMedGoogle Scholar
  85. 85.
    Vera Z, Mason DT, Fletcher RD, et al. Prolonged His-Q interval in chronic bifascicular block. Relation to impending complete heart block. Circulation. 1976;53:46–55.Google Scholar
  86. 86.
    Narula OS. Longitudinal dissociation in the His bundle. Bundle branch block due to asynchronous conduction within the His bundle in man. Circulation. 1977;56:996–1006.PubMedGoogle Scholar
  87. 87.
    El-Sherif N, Amat-Y-Leon P, Schoenfield C, et al. Normalization of bundle branch block patterns by distal His bundle pacing. Clinical and experimental evidence of longitudinal dissociation in the pathologic His bundle. Circulation. 1978;57(3):473–83.PubMedGoogle Scholar
  88. 88.
    Kaufman R, Rothberger CJ. Beitrage zur entstehungsweise extrasysolischer allorhythmien (Zweite Mitteilung). Z Gesamte Exp Med. 1919;7:199.Google Scholar
  89. 89.
    Condorelli L. Schenkelblock durch Laesion des Tawaraknotens. Sonderabdruck aus den Verhandlungen der Deutschen Gesellschaft fur Kreislauforschung, 1932.Google Scholar
  90. 90.
    Sciacca A, Sangiorgi M. Trouble de la conduction intraventriculaire droite du a la lesion du tronc commun du faiseau de His. Acta Cardiol. 1957;2:486.Google Scholar
  91. 91.
    James TN, Sherf L. Fine structure of the His bundle. Circulation. 1971;44:9.PubMedGoogle Scholar
  92. 92.
    Deshmukh R, Casavant DA, Romanyshyn M, Anderson K. Permanent, direct His-bundle pacing: a novel approach to cardiac pacing in patients with normal His-Purkinje activation. Circulation. 2000;101:869–77.PubMedGoogle Scholar
  93. 93.
    Lustgarten DL, Crespo EM, Arkhipova-Jenkins I, et al. His-bundle pacing versus biventricular pacing in cardiac resynchronization therapy patients: a crossover design comparison. Heart Rhythm. 2015;12:1548–57.PubMedGoogle Scholar
  94. 94.
    Sharma RS, Dandamudi G, Herweg B, et al. Permanent His-bundle pacing as an alternative to biventricular pacing for cardiac resynchronization therapy: a multicenter experience. Heart Rhythm. 2018;15:413–20.PubMedGoogle Scholar
  95. 95.
    Ali N, Keene D, Arnold A, Shun-Shin M, et al. His bundle pacing: a new frontier in the treatment of heart failure arrhythm. Electrophysiol Rev. 2018;7(2):103–10.Google Scholar
  96. 96.
    Rosenbaum MB, Elizari MV, Levi RJ, Nau GJ. Paroxysmal atrioventricular block related to hypopolarization and spontaneous diastolic depolarization. Chest. 1973;63:678–88.PubMedGoogle Scholar
  97. 97.
    Langendorf R. The role of spontaneous diastolic depolarization in second degree A-V block: the mechanism of “paroxysmal” A-V block and of a new form of pseudo-supernormal A-V conduction (editorial). Chest. 1973;63:652–5.Google Scholar
  98. 98.
    El-Sherif N, Scherlag BJ, Lazzara R, Hope R, Williams DO, Samet P. The pathophysiology of tachycardia-dependent paroxysmal atrioventricular block after myocardial ischemia. Experimental and clinical observations. Circulation. 1974;50:515–28.PubMedGoogle Scholar
  99. 99.
    Coumel P, Fabiato A, Waynberger M, Motte G, Slama R, Bouvrain Y. Bradycardia-dependent atrioventricular 7lock. Report of two cases of A-V block elicited by premature beats. J Electrocardiol. 1971;4:168–77.PubMedGoogle Scholar
  100. 100.
    Shenasa M, Josephson ME, Wit AL. Paroxysmal atrioventricular block: electrophysiological mechanism of phase 4 conduction block in the His-Purkinje system: a comparison with phase 3 block. Pacing Clin Electrophysiol. 2017;40:1234–41.PubMedGoogle Scholar
  101. 101.
    Shohat-Zxabarski R, Lakobishvilli Z, Kusniec J, Mazur A, Strasberg B. Paroxysmal atrioventricular block: clinical experience with 20 patients. Int J Cardiol. 2004;97:399–405.Google Scholar
  102. 102.
    El-Sherif N, Jalife J. Paroxysmal atrioventricular block: are phase 3 and phase 4 block mechanisms or misnomers? Heart Rhythm. 2009 October;6(10):1514–21.PubMedPubMedCentralGoogle Scholar
  103. 103.
    Brignole M, Meozzi C, Moya A, et al. Mechanism of syncope in patients with bundle branch block and negative electrophysiological test. Circulation. 2002;104:2045–50.Google Scholar
  104. 104.
    Erlanger J. On the physiology of heart block in mammals with special reference to causation of Stokes-Adams disease. J Exp Med. 1906;8:8–58.PubMedPubMedCentralGoogle Scholar
  105. 105.
    Stock RJ, Macken DL. Observations on heart block during continuous electrocardiographic monitoring in myocardial infarction. Circulation. 1968;38:993–1005.PubMedGoogle Scholar
  106. 106.
    McHenry PL, Knoebel SB. Acceleration of the sinoatrial rate leading to complete heart block, an unusual mechanism for the Adams-Stokes syndrome. Am Heart J. 1966;72:681–5.PubMedGoogle Scholar
  107. 107.
    Donoso E, Adler LN, Friedberg CK. Unusual forms of second-degree atrioventricular block, including Mobitz type II block associated with the Morgagni-Adams-Stokes syndrome. Am Heart J. 1964;67:150–7.PubMedGoogle Scholar
  108. 108.
    Schwartz SP, Schwartz LS. Adams-Stokes syndrome normal sinus rhythm and transient heart block. III. The paradoxical effects of carotid sinus digital pressure and deep breathing on patients with Adams-Stokes seizures during normal sinus rhythm and transient heart block. Am J Cardiol. 1961;7:204–10.PubMedGoogle Scholar
  109. 109.
    Langendorf R, Pick A. Concealed conduction. Further evaluation of a fundamental aspect of propagation of the cardiac impulse. Circulation. 1956;13:381–99.PubMedGoogle Scholar
  110. 110.
    Langendorf R, Pick A. Concealed intraventricular conduction in the human heart. Adv Cardiol. 1975;14:40–50.PubMedGoogle Scholar
  111. 111.
    Ursell S, Habbab MA, El-Sherif N. Atrioventricular and intraventricular conduction disorders: clinical aspects. In: El-Sherif N, Samet P, editors. Cardiac pacing and electrophysiology. Philadelphia: W.B. Saunders Co.; 1991. p. 140–69.Google Scholar
  112. 112.
    Narula OS, Rung M. Accommodation of A-V nodal conduction and fatigue phenomenon in the His-Purkinje system. In: Wellens HJJ, Lie KI, Janse MJ, editors. The conduction system of the heart. Philadelphia: Lea and Febiger; 1976. p. 529–44.Google Scholar
  113. 113.
    Sasano T, Okishige K, Azegami K, Ohira H, Yamashita K, Satake S. Transient complete atrioventricular block provoked by ventricular pacing in a patient with nonsustained ventricular tachycardia. J Electrocardiol. 1999;32:185–90.PubMedGoogle Scholar
  114. 114.
    Cranfield PF, Klein HO, Hoffman BF. Conduction of the cardiac impulse. I. Delay, block and oneway block in depressed Purkinje fibers. Circ Res. 1971;28:199–209.Google Scholar
  115. 115.
    Jalife J, Antzelevitch C, Lamanna V, Moe GK. Rate-dependent changes in excitability of depressed cardiac Purkinje fibers as a mechanism of intermittent bundle branch block. Circulation. 1983;67:912–22.PubMedGoogle Scholar
  116. 116.
    Sinhal A, Altwegg L, Pasupati S, et al. Atrioventricular block after transcatheter balloon expandable aortic valve implantation. JACC Cardiovasc Interv. 2008;1:305–9.PubMedGoogle Scholar
  117. 117.
    Saji M, Murai T, Tobaru T, Tabata M, Takanashi S, Takayama M. Autopsy finding of the Sapien XT valve from a patient who died suddenly after transcatheter aortic valve replacement. Cardiovasc Interv Ther. 2013;28:267–71.PubMedGoogle Scholar
  118. 118.
    Moreno R, Dobarro D, López de Sá E, et al. Cause of complete atrioventricular block after percutaneous aortic valve implantation: insights from a necropsy study. Circulation. 2009;120:29–30.Google Scholar
  119. 119.
    Osnabrugge RL, Mylotte D, Head SJ, et al. Aortic stenosis in the elderly: disease prevalence and number of candidates for transcatheter aortic valve replacement: a meta-analysis and modeling study. J Am Coll Cardiol. 2013;62:1002–12.PubMedGoogle Scholar
  120. 120.
    Abdel-Wahab M, Mehilli J, Frerker C, et al. Comparison of balloon-expandable vs self-expandable valves in patients undergoing transcatheter aortic valve replacement: the CHOICE randomized clinical trial. JAMA. 2014;311:1503–14.PubMedGoogle Scholar
  121. 121.
    Erkapic D, De Rosa S, Kelava A, Lehmann R, Fichtlscherer S, Hohnloser SH. Risk for permanent pacemaker after transcatheter aortic valve implantation: a comprehensive analysis of the literature. J Cardiovasc Electrophysiol. 2012;23:391–7.PubMedGoogle Scholar
  122. 122.
    Jilaihawi H, Chakravarty T, Weiss RE, et al. Meta-analysis of complications in aortic valve replacement: comparison of Medtronic-Corevalve, Edwards-Sapien and surgical aortic valve replacement in 8,536 patients. Catheter Cardiovasc Interv. 2012;80:128–38.PubMedGoogle Scholar
  123. 123.
    Rodés-Cabau J. Transcatheter aortic valve implantation: current and future approaches. Nat Rev Cardiol. 2011;9:15–29.PubMedGoogle Scholar
  124. 124.
    Khatri PJ, Webb JG, Rodés-Cabau J, et al. Adverse effects associated with transcatheter aortic valve implantation: a meta-analysis of contemporary studies. Ann Intern Med. 2013;158:35–46.PubMedGoogle Scholar
  125. 125.
    Manoharan G, Walton AS, Brecker SJ, et al. Treatment of symptomatic severe aortic stenosis with a novel resheathable supra-annular self-expanding transcatheter aortic valve system. JACC Cardiovasc Interv. 2015;8:1359–67.PubMedGoogle Scholar
  126. 126.
    Sinning JM, Petronio AS, Van Mieghem N, et al. Relation between clinical best practices and 6-month outcomes after transcatheter aortic valve implantation with core valve (from the Advance II Study). Am J Cardiol. 2017;119:84–90.PubMedGoogle Scholar
  127. 127.
    Siontis GC, Jüni P, Pilgrim T, et al. Predictors of permanent pacemaker implantation in patients with severe aortic stenosis undergoing TAVR: a meta-analysis. J Am Coll Cardiol. 2014;64:129–40.PubMedGoogle Scholar
  128. 128.
    Nazif TM, Dizon JM, Hahn RT, et al. Predictors and clinical outcomes of permanent pacemaker implantation after transcatheter aortic valve replacement: the PARTNER (Placement of AoRtic TraNscathetER Valves) trial and registry. JACC Cardiovasc Interv. 2015;8:60–9.PubMedGoogle Scholar
  129. 129.
    Urena M, Webb JG, Tamburino C, et al. Permanent pacemaker implantation after transcatheter aortic valve implantation: impact on late clinical outcomes and left ventricular function. Circulation. 2014;129:1233–43.PubMedGoogle Scholar
  130. 130.
    van der Boon RM, Van Mieghem NM, Theuns DA, et al. Pacemaker dependency after transcatheter aortic valve implantation with the self-expanding Medtronic CoreValve System. Int J Cardiol. 2013;168:1269–73.PubMedGoogle Scholar
  131. 131.
    Simms AD, Hogarth AJ, Hudson EA, et al. Ongoing requirement for pacing post-transcatheter aortic valve implantation and surgical aortic valve replacement. Interact Cardiovasc Thorac Surg. 2013;17:328–33.PubMedPubMedCentralGoogle Scholar
  132. 132.
    Fadahunsi OO, Olowoyeye A, Ukaigwe A, et al. Incidence, predictors, and outcomes of permanent pacemaker implantation following transcatheter aortic valve replacement: analysis from the U.S. Society of Thoracic Surgeons/American College of Cardiology TVT Registry. JACC Cardiovasc Interv. 2016;9:2189–99.PubMedGoogle Scholar
  133. 133.
    Biner S, Michowitz Y, Leshem-Rubinow E, et al. Hemodynamic impact and outcome of permanent pacemaker implantation following transcatheter aortic valve implantation. Am J Cardiol. 2014;113:132–7.PubMedGoogle Scholar
  134. 134.
    Muñoz-García AJ, Hernández-García JM, Jiménez-Navarro MF, et al. Factors predicting and having an impact on the need for a permanent pacemaker after CoreValve prosthesis implantation using the new Accutrak delivery catheter system. JACC Cardiovasc Interv. 2012;5:533–9.PubMedGoogle Scholar
  135. 135.
    Ledwoch J, Franke J, Gerckens U, et al. Incidence and predictors of permanent pacemaker implantation following transcatheter aortic valve implantation: analysis from the German transcatheter aortic valve interventions registry. Catheter Cardiovasc Interv. 2013;82:E569–77.PubMedGoogle Scholar
  136. 136.
    De Carlo M, Giannini C, Bedogni F, et al. Safety of a conservative strategy of permanent pacemaker implantation after transcatheter aortic CoreValve implantation. Am Heart J. 2012;163:492–9.PubMedGoogle Scholar
  137. 137.
    Chorianopoulos E, Krumsdorf U, Pleger ST, Katus HA, Bekeredjian R. Incidence of late occurring bradyarrhythmias after TAVI with the self-expanding CoreValve(®) aortic bioprosthesis. Clin Res Cardiol. 2012;101:349–55.PubMedGoogle Scholar
  138. 138.
    Bagur R, Rodés-Cabau J, Gurvitch R, et al. Need for permanent pacemaker as a complication of transcatheter aortic valve implantation and surgical aortic valve replacement in elderly patients with severe aortic stenosis and similar baseline electrocardiographic findings. JACC Cardiovasc Interv. 2012;5:540–51.PubMedGoogle Scholar
  139. 139.
    Calvi V, Conti S, Pruiti GP, et al. Incidence rate and predictors of permanent pacemaker implantation after transcatheter aortic valve implantation with self-expanding CoreValve prosthesis. J Interv Card Electrophysiol. 2012;34:189–95.PubMedGoogle Scholar
  140. 140.
    van der Boon RM, Nuis RJ, Van Mieghem NM, et al. New conduction abnormalities after TAVI--frequency and causes. Nat Rev Cardiol. 2012;9:454–63.PubMedGoogle Scholar
  141. 141.
    Mauri V, Reimann A, Stern D, et al. Predictors of permanent pacemaker implantation after transcatheter aortic valve replacement with the SAPIEN 3. JACC Cardiovasc Interv. 2016;9:2200–9.PubMedGoogle Scholar
  142. 142.
    Rivard L, Schram G, Asgar A, et al. Electrocardiographic and electrophysiological predictors of atrioventricular block after transcatheter aortic valve replacement. Heart Rhythm. 2015;12:321–9.PubMedGoogle Scholar
  143. 143.
    Naveh S, Perlman GY, Elitsur Y, et al. Electrocardiographic predictors of long-term cardiac pacing dependency following transcatheter aortic valve implantation. J Cardiovasc Electrophysiol. 2017;28:216–23.PubMedGoogle Scholar
  144. 144.
    Ando G, Versaci F. Ventriculo-atrial gradient due to first degree atrio-ventricular block: a case report. BMC Cardiovasc Disord. 2005;5:23.PubMedPubMedCentralGoogle Scholar
  145. 145.
    Carroz P, Delay D, Girod G. Pseudo-pacemaker syndrome in a young woman with first degree atrio-ventricular block. Europace. 2010;12:594–6.PubMedGoogle Scholar
  146. 146.
    Brignole M, Deharo JC, De Roy L, et al. Syncope due to idiopathic paroxysmal atrioventricular block: long-term follow-up of a distinct form of atrioventricular block. J Am Coll Cardiol. 2011;58:167–73.PubMedGoogle Scholar
  147. 147.
    Kusumoto FM, Schoenfeld MH, Barrett C, et al. 2018 ACC/AHA/HRS guideline on the evaluation and management of patients with bradycardia and cardiac conduction delay. J Am Coll Cardiol. 2019;74(7):932–87. Scholar
  148. 148.
    European Society of Cardiology (ESC), European Heart Rhythm Association (EHRA), Brignole M, et al. ESC guidelines on cardiac pacing and cardiac resynchronization therapy: the task force on cardiac pacing and resynchronization therapy of the European Society of Cardiology (ESC). Developed in collaboration with the European Heart Rhythm Association (EHRA). Europace. 2013;15:1070–118.Google Scholar
  149. 149.
    Mendoza-Davila N, Veron J. Karel Wenckebach: the story behind the block. Elsevier Resuscitation. 2008;79:189–02.Google Scholar
  150. 150.
    Elizari MV. A revolutionary electrocardiologist from the southern hemisphere, 1921–2003. Circulation. 2003;108:780–1.Google Scholar

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© Springer Nature Switzerland AG 2020

Authors and Affiliations

  1. 1.Icahn School of MedicineMount Sinai HospitalNew YorkUSA

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