---
abstract: 'This ECG was recorded from a 93 year old patient with a previously documented third degree AV block and an underlying LBBB. The twelve lead ECG demonstrates sinus bradycardia at a rate of 52 beats per minute, a PR interval  of 230 milliseconds, and a left bundle branch block (Figure 1).  In figure 2, a rhythm strip of leads V1, II and V5 shows sinus rhythm with AV block. Note that only P waves in the T wave of the paced beat are conducted.  The non-conducted P waves are followed by ventricular paced beats at an escape interval of 1200 milliseconds.  '
altloc:
  - http://www.ipej.org/0603/friedman.htm
chapter: ~
commentary: ~
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contact_email: ~
creators_id: []
creators_name:
  - family: Friedman
    given: Meir
    honourific: ''
    lineage: ''
  - family: Schweitzer
    given: Paul
    honourific: ''
    lineage: ''
date: 2006-07
date_type: published
datestamp: 2006-10-28
department: ~
dir: disk0/00/00/52/38
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editors_id: []
editors_name:
  - family: Singh
    given: Balbir
    honourific: ''
    lineage: ''
  - family: Lokhandwala
    given: Yash
    honourific: ''
    lineage: ''
  - family: Francis
    given: Johnson
    honourific: ''
    lineage: ''
  - family: Gupta
    given: Anup
    honourific: ''
    lineage: ''
  - family: Ghosh
    given: Joydeep
    honourific: ''
    lineage: ''
eprint_status: archive
eprintid: 5238
fileinfo: /style/images/fileicons/text_html.png;/5238/1/friedman.htm|/style/images/fileicons/application_pdf.png;/5238/2/friedman.pdf
full_text_status: public
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ispublished: pub
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keywords: ~
lastmod: 2011-03-11 08:56:41
latitude: ~
longitude: ~
metadata_visibility: show
note: ~
number: 3
pagerange: 182-183
pubdom: TRUE
publication: Indian Pacing and Electrophysiology Journal
publisher: Indian Pacing and Electrophysiology Group
refereed: TRUE
referencetext: |
  1. Pick A, Langerdorf R, Katz LN. The supernormal phase of atrioventricular conduction. I Fundamental mechanisms. Circulation 1962; 26: 388-404.
  
  2. Schamroth L. The disorder of cardiac rhythm.  Blackwell Scientific publications, Oxford and Edinburgh.  1971; 271-279.
  
  3. Rashid A, Massumi RA, Amsterdan EA, Mason DT. Phenomenon of supernormality in the human heart. Circulation 1972; 46:264-275.
  
  4. Moe GK, Childers RW, Merideth J.  An appraisal of supernormal AV conduction. Circulation 1968; 38:5-28.
  
  5. Gallagher JJ, Damato AN, Varghese PJ, Caracta AR, Josephson ME, Lau SH. Alternative mechanisms of apparent supernormal atrioventricular conduction.  Am J Cardiol. 1973;31: 362-371. 
relation_type: []
relation_uri: []
reportno: ~
rev_number: 14
series: ~
source: ~
status_changed: 2007-09-12 17:08:14
subjects:
  - ipej
succeeds: ~
suggestions: ~
sword_depositor: ~
sword_slug: ~
thesistype: ~
title: "Transient unexpected improvement of AV conduction: What is the mechanism?\n"
type: journalp
userid: 4424
volume: 6
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