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A Case of Pause-Dependent Atrioventricular Block with Ventricular Arrhythmias Following Redo Bentall Procedure
Journal article   Open access   Peer reviewed

A Case of Pause-Dependent Atrioventricular Block with Ventricular Arrhythmias Following Redo Bentall Procedure

Mohammed Mhanna, Denice Hodgson-Zingman and Brian Olshansky
Indian pacing and electrophysiology journal
07/28/2026
DOI: 10.1016/j.ipej.2026.07.013
PMID: 42520853
url
https://doi.org/10.1016/j.ipej.2026.07.013View
Published (Version of record) Open Access

Abstract

A 63-year-old male with prior aortic valve replacement and Bentall procedure for E. faecalis endocarditis developed paroxysmal atrioventricular (AV) block after repeat Bentall surgery. Telemetry demonstrated PVC-triggered phase 4 block leading to high-grade AV block, prolonged pauses, and polymorphic ventricular tachycardia. A temporary permanent pacemaker was implanted, followed by ventricular leadless pacemaker placement. This case highlights the malignant potential of phase 4 block, particularly when combined with postoperative conduction system disease, and underscores the importance of early recognition and pacing support.

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