Tj. Cohen et S. Cayenne, EXERCISE-INDUCED ATRIOVENTRICULAR-BLOCK REVISITED - CASE-REPORT AND REVIEW, The Journal of invasive cardiology, 9(7), 1997, pp. 500-503
Exercise causes enhanced sympathetic discharge and results in physiolo
gic tachycardia. However, in certain patients with a diseased conducti
on system, exercise can precipitate heart block. The sinus and atriove
ntricular nodes are innervated by the autonomic nervous systems. The H
is-Purkinje system is relatively devoid of autonomic nerve supply. Hen
ce the former and not the latter is influenced more by autonomic stimu
lation. During exercise, conduction improves across the atrioventricul
ar node which can stress the His-Purkinje system and lead to heart blo
ck in those with significant His-Purkinje disease. In this report, we
discuss a recent case of exercise-induced heart block confirmed by ele
ctrophysiology study and briefly review this subject.