We present a case of a woman with an asymptomatic intermittent 2:1 atrioventricular block. The baseline ECG showed a wide QRS with right bundle branch block pattern. Measurement of the HV interval during electrophysiological study was normal. During electrophysiological stimulation, a unique pattern of paradoxical conduction was seen. We discuss the mechanism of the paradoxical conduction.
Keywords: Atrioventricular block; Gap phenomenon; Infrahisian block; Phase 4 block; Supranormal conduction.
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