I’ve never seen this. Was the atrial mechanical sensed event generated by retrograde conduction? Do you have a tracing?

There are reversible causes of AV block (ischemia, infectious, metabolic, inflammatory, iatrogenic). These should be entertained and worked up based on index of suspicion. No, the majority of heart block patients should not undergo LHC. The majority of AV block is predominantly age related.

ECG post revascularization. A nice example of a reversable cause of AV block. #ECGSky #CardioSky #MedSky

LHC revealed a 90-95% Prox-Md RCA stenosis. #ECGSky #Cardiosky #MedSky

An additional ECG from admission, and a prior ECG (2 months previously).

I’m okay weaning/stopping GDMT in a patient with an arrhythmia mediated myopathy, when rhythm control has resulted in recovery of function. cMR can be helpful if concerned for additional nonischemic substrate.

Over treatment has its harms too.

Wean-HF (clinicaltrials.gov/study/NCT061...)

POD#0 from cardiac surgery with epicardial pacing wire undersensing or likely asynchronously pacing, some of the captured beats falling on the T-wave! 😬

Tale as old as time...

Of course, @narrowqrs.bsky.social has a video for this!
www.youtube.com/watch?v=dpVe...

Would like to be included! Thank you.