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Atrioventricular block (AVB) is defined as delay or absence of transmission of one or more atrial excitations to the ventricle. Physiological functional block protects the ventricle against very rapid atrial rhythms. Organic blocks may be transient, due to an acute regressive condition, or chronic, in which case they fall into two groups--permanent blocks or paroxysmal and generally rate-dependant blocks. The blocks are classified in three categories according to whether the atrial activation is delayed, conducted intermittently or not at all. The site of AVB may be determined by His bundle recordings but it may also be deduced from the surface ECG recording. Fundamental studies have questioned the reality of Rosenbaum's phase 3 and 4 blocks and suggest abnormalities of excitability in pathological zones.
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