Infra-Hisian block as cause of Wenckebach's phenomenon in an asymptomatic middle-aged man.

We report the case of a 60-year-old man with asymptomatic sinus bradycardia and Holter recording showing episodes of Wenckebach block alternating with episodes of 2:1 block. Electrophysiological testing revealed Infra-Hisian block with progressive prolongation of the H-V interval resulting in block after H potential. This produced typical Wenckebach-type block on surface electrocardiogram resembling the clinical one.

Efficacy and safety of ibutilide for cardioversion of atrial flutter and fibrillation in patients receiving amiodarone or propafenone.

Aim: The effectiveness and safety of ibutilide (IB) use in patients receiving amiodarone or propafenone for atrial flutter (AFL) and atrial fibrillation (AF) were compared to IB alone.

Methods And Results: In 104 consecutive patients with AF (65%) or AFL (35%), receiving amiodarone (n = 46), propafenone (n = 30), or no specific antiarrhythmic drug (n = 28), IB was given for cardioversion. Fifteen patients in amiodarone group were loaded with 1.