Korean J Med.  2015 Jul;89(1):74-78. 10.3904/kjm.2015.89.1.74.

Reversible Atrioventricular Block after Electrical Injury

• Lee JY
• Rhyou HI
• Choi WJ
• Jung HJ
• Lee S
• Park JS

• KMID: 2269053
• DOI: http://doi.org/10.3904/kjm.2015.89.1.74

Abstract

Here, we report a case of electrical injury-induced reversible advanced second-degree atrioventricular (AV) block. A 28-year-old male visited the emergency department for palpitations 3 days after receiving an electrical injury from 220 volt alternating current. The initial electrocardiogram (ECG) showed sinus rhythm and first-degree AV block with a prolonged PR interval of 400 ms. There was no structural heart disease or electrolyte imbalance. Follow up ECGs acquired 4-6 days after the electrical injury showed intermittent AV block with a prolonged PR interval of 400-460 ms. Exercise treadmill and atropine provocation tests performed 6 days after electrical injury induced advanced second-degree AV block. His bundle electrogram showed intermittent AH block in a Wenckebach pattern with a prolonged AH interval of 220-360 ms and a normal HV interval. Episodes of AV block decreased remarkably 4 weeks after the electrical injury, and the prolonged PR interval returned to 220 ms after 5 months.

Keyword

Electricity; Atrioventricular block

MeSH Terms

Adult
Atrioventricular Block*
Atropine
Electricity
Electrocardiography
Electrophysiologic Techniques, Cardiac
Emergency Service, Hospital
Follow-Up Studies
Heart Diseases
Humans
Male
Atropine