Auriculoventricular nodal rhythm with heart block

Abstract

Two cases of upper nodal rhythm associated with auriculoventricular heart block or antegrade block are presented. The first case shows the transitory development of an upper nodal rhythm with first degree auriculoventricular heart block, in an elderly hypertensive patient, soon after an attack of acute pulmonary edema. The second case is of unusual interest, exhibiting as it does phases of (1) normal sinus rhythm, (2) uncomplicated upper nodal rhythm, (3) nodal tachycardia with 2 to 1 auriculoventricular antegrade block, and (4) nodal tachycardia with instances of 2 to 1 block, first degree heart block, and nodal pauses. Another feature of unusual interest is the regular appearance of a coronary S-T-T pattern during phases of nodal rhythm.