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Paroxysmal atrioventricular block: A case report

Year: 2026

Type: article

Abstract: Background Paroxysmal atrioventricular block (PAVB) is an abrupt shift from normal conduction to complete heart block. Because episodes are transient and ECGs may appear normal between events, the condition is frequently overlooked. Case Report A 73-year-old male presented with recurrent near-syncope and intermittent bradycardia. In the ED, a premature atrial complex triggered sudden complete heart block without preceding PR or sinus slowing, consistent with intrinsic PAVB. He required transcutaneous and then transvenous pacing, and ultimately received a leadless ventricular pacemaker. Coronary angiography showed chronic disease unlikely to explain his conduction abnormality, and he remained asymptomatic at one year. Why Should an Emergency Physician Be Aware of This? PAVB is life-threatening and easily missed without continuous monitoring. Early identification and prompt pacing are critical to prevent prolonged asystole and sudden cardiac death.

Source: JEM Reports

DOI: 10.1016/j.jemrpt.2026.100232

Authors: Avi Patel, Chaitanya Malladi, Gordon Ho, Alan You

Institution: University of California San Diego

Language: English

Topic: Cardiac electrophysiology and arrhythmias

Subfield: Cardiology and Cardiovascular Medicine

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: gold

Estimated APC paid: $720