Dual Atrioventricular Conduction during Sinus Rhythm

pp 281-283

Abstract

The double physiology of atrioventricular node (AVN) is rarely expressed in the electrocardiogram during sinus rhythm. Here we present the case of a sixty-six years old woman, with a history of mild hypertension and supraventricular tachycardia with a control ECG in sinus rhythm with complex QRS coupled and unusually long PR interval, resulting from the dual conduction of a sinus beat. This means: two complex QRS for each P wave. Sinus carotid compression was a key for diagnostic interpretation. This ECG manifestation of a double nodal pathway is the strangest expression of this disturbance, and the knowledge of this way of conduction through AVN helped us to understand complex tracings during sinus rhythm.