부산대학교 도서관

A case of right bundle branch and left anterior superior division block-bifascicular block, developing into intermittent complete heart block-trifasciular block is described. Atrial stimulation produced Wenckebach periods, Mobitz type II conduction defect, with block below the His-bundle area and at the AV node and complete heart block. His-bundle electrography documented the Wenckebach’s phenomenon as occurring below the His bundle in the only conducting fascicle, post inferior division of the left bundle. During atrial stimulation a phenomenon of concealed conduction into the infra-His conduction system was also noted. Implantation of a permanent cardiac pacemaker abolished symptoms of syncope.