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New Emirates Medical Journal

Volume 1, 2 Issues, 2020
ISSN: 0250-6882 (Online)
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Open Access Article

A Case of 2:1 Atrio-Ventricular Block- Unraveled by Exercise Testing

Sharada S. Kalavakolanu1, *, Madan M. Balakrishnan1, Deepesh Venkataraman1
1 Department of Cardiology, MGM Healthcare, Aminjikarai, Chennai, Tamilnadu, India


We present a case of a 75-year-old lady with effort intolerance and baseline ECG showing 2:1 atrioventricular block, in whom it was unclear as to the requirement of permanent pacing, even after long term ECG monitoring. She underwent a treadmill test during which her QRS became wide and developed complete heart block within 2 minutes of the test. Thus, a simple exercise test confirmed the level of the block to be infra nodal without the need for the invasive study. In patients with exertional symptoms, even in elderly, and in those where ECG masquerades as a benign entity, exercise testing is useful to differentiate benign cases of atrioventricular block from the more serious cases that mandate pacemaker implantation.

Keywords: Atrioventricular block, Complete heart block, Exercise test, Intra-Hisian block, Infra nodal, Coronary angiogram.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 1
Issue: 2
First Page: 57
Last Page: 60
Publisher Id: nemj-1-57
DOI: 10.2174/0250688202002022001

Article History:

Received Date: 17/10/2019
Revision Received Date: 01/02/2020
Acceptance Date: 10/02/2020
Electronic publication date: 15/07/2020
Collection year: 2020

© 2020 Kalavakolanu et al.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: ( This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the Department of Cardiology MGM Healthcare, Nelson Manickam Road, Aminjikarai, Chennai, Tamilnadu, 600029, India; Tel: +91 44 45242444; E-mail:


Abdullah Shehab
Emirates Cardiac Society
Emirates Medical Association

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Average review speed: 45 days average

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