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Date of download: 6/22/2016 Copyright © The American College of Cardiology. All rights reserved. From: Global distribution of atrial ectopic foci triggering.

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Pugazhendhi Vijayaraman et al. JACEP 2015;1:571-581 Intra-HIs AV Block (A) Discrete intra-His AV block. Twelve-lead electrocardiogram and bipolar electrogram from the permanent His bundle pacing (HBP) (His) lead in a patient with atrial fibrillation (AF), advanced infranodal AV block, and narrow QRS is shown. (B) Pacing from the HBP lead at 900 ms results in selective capture of the distal main His bundle and conduction with a narrow QRS. Note the dissociated proximal His bundle potential recorded from the pacing lead during AF. (C) Atrial pacing after cardioversion at 800 ms results in 2:1 HV block. (D) Pacing from the HBP at decreasing cycle lengths of 500, 450, and 400 ms results in 1:1 anterograde conduction through the distal His bundle with narrow QRS and 1:1 retrograde conduction to the atrium. This example illustrates the discrete nature of the intra-His AV block and correction by selective His bundle pacing (S-HBP). Pugazhendhi Vijayaraman et al. JACEP 2015;1:571-581 American College of Cardiology Foundation