A rare association of complete atrio-ventricular block and preexcitation: case report

  • Myriam Lahraoui Dr
Keywords: Complete atrioventricular block, Wolff Parkinson White, Pre-excitation syndrome


Complete atrioventricular block (AVB) associated with an accessory pathway is a rare phenomenon. We report a case of high degree AVB on Wolff Parkinson White (WPW) syndrome associated with an accessory pathway in a 60-year-old female patient. The electrocardiogram (ECG) on admission showed a regular sinus rhythm with a short PR interval and a QRS notch with a transition to conductive disturbances, specifically a complete AVB and a transition to a 2/1 AVB. The patient underwent endocavitary exploration, which revealed a pre-excitation in the right anteroseptal position with a long refractory period, justifying its non-ablation. She then underwent implantation of a double-chamber pacemaker with simple follow-up and regular monitoring in the rythmology clinic. This case report describes this rare association and highlights the conduction duality of the normal nodo-hissian pathway and the accessory pathway.


Download data is not yet available.


1- A. Moustaghfir et al. Les troubles de la conduction du mécanisme au traitement. Septembre 2005: 49-78.

2- A. Moustaghfir et al. Les arythmies supraventriculaires. Septembre 2012:147-176.

3- Takagi Y, Watanabe I, Masaki R, Okumura Y, Yamada T, Wakita R et al. Complete AV block developing in a patient with manifest ventricular preexcitation. Int Heart J 2005; 46:729-35.

4-V.Palanca et al. Intermittent Atrioventricular Block in an Accessory Pathway associated With Complete Infra-Hissian Block. Rev Esp Cardiol 2004;57(4):363-6

5. Liu S, Olsson S.B, Hertervig E, Kongstad O, Yuan S. Atrioventricular conduction: a determinant for the manifestation of ventricular preexcitation in patients with Wolff Parkinson White syndrome. Clinical Physiology 2001; 21:534-540.

6. Chaib A, Bouzelmat H, Boulaamayel S, Kheyi J, Moustaghfir A. Une pré-excitation en bloc. Presse Med 2014; 43:480-482.

7. Erdogan O. A rare coexistence of complete atrioventricular block and preexcitation in an elderly symptomatic patient. JCardiovasc Med 2008;9(7):729-732.

8. Erickson C, Yetman A T, Jones C S, Duncan W T. Late Onset of Accessory Pathway Conduction in a Patient with Complete AV Block. Pacing and Clinical Electrophysiology 2000;23(2):280-282.

9. Dinckal M H, Davutoglu V, Bayata S. Masked Complete Atrioventricular Block in a Patient with Ventricular Preexcitation. J Interv Card Electrophysiol 2004;11:33-35.

10- F. Boustani . L’essentiel en cardiologie, consensus cardio pour le praticien - N° 76 • Février 2012: 161-168.

11. Singh B, Sudan D, Kaul U. Transient complete atrioventricular block following radiofrequency ablation of left free wall accessory pathway. J Inter Card Electrophysiol 1998;2:305- 307.
How to Cite
Lahraoui, M. (2023). A rare association of complete atrio-ventricular block and preexcitation: case report. GPH-International Journal of Biological & Medicine Science, 6(09), 01-06. https://doi.org/10.5281/zenodo.10000315