Atypical Wenckebach without grouped beating due to dual AV nodal conduction

John M. Cunningham, Ann Mackey, Charles Tharp

Research output: Contribution to journalArticlepeer-review


A 31-year-old woman reported dizziness in the early postpartum period after receiving dexmedetomidine. The ECG was misinterpreted as complete heart block; however, more careful analysis revealed an atypical Wenckebach pattern with dual AV nodal conduction and termination of nonconducted P waves with junctional escape beats. The patient's rhythm returned to sinus after stopping dexmedetomidine. Atypical Wenckebach patterns account for greater than 50% of patients with Mobitz Type I AV block and can be misinterpreted as high-grade AV block. This case highlights the causes of atypical Wenckebach patterns and how careful analysis of intervals can help clinicians avoid misdiagnosis.

Original languageEnglish (US)
Pages (from-to)83-85
Number of pages3
JournalJournal of Electrocardiology
StatePublished - Jan 1 2024


  • Atypical Wenckebach
  • Dual AV nodal conduction
  • Electrocardiology

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine


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