The 12-lead electrocardiogram (ECG) of a 79-year-old male patient with recurrent pre-syncope showed irregular sinus rhythm with constant PR interval and left bundle branch block (LBBB) with intermittently blocked P waves. The beat following the blocked P wave had a narrower QRS with a shorter PR interval. The phenomenon of bilateral bundle branch block explains the sudden improvement in the atrioventricular conduction.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8263326PMC
http://dx.doi.org/10.1016/j.ipej.2021.05.001DOI Listing

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