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Mobitz Type II Block With Narrow QRS Complex and Stokes-Adams Attacks

Kenneth M. Rosen, MD; Henry S. Loeb, MD; Shahbudin H. Rahimtoola, MB, FRCP
Arch Intern Med. 1973;132(4):595-596. doi:10.1001/archinte.1973.03650100103019.
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Mobitz type II block usually occurs in patients with bundle-branch block implying bilateral bundle-branch disease and a poor prognosis.1-4 The site of block in such cases is distal to the His bundle recording site.5 We have recently reported three patients with type II block with narrow QRS complex and a site of block proximal to the His bundle.6 The conduction defects in these patients were not progressive, suggesting that type II block proximal to the His bundle was a benign condition.

Simultaneously with the publication of this latter study, we have seen a patient with type II block proximal to the His bundle, a narrow QRS complex, and prolonged periods of asystole. This patient is the subject of the present report.

Patient Summary  The patient was a 65-year-old man admitted to Cook County Hospital on Dec 3, 1971, with a history of syncope. While waiting in the


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