Atypical vagal Wenckebach period in a high performance athlete

A 27-year-old man, engaged in heavy physical training, exhibited sinusbradyarrhythmia with atrial abnormality and second degree av-block (atypical Wenckebach period). Since abnormal sinusrhythms was established with exercise and following parasympathetic blockade, this rhythm disorder was considered consequential exaggerated vagal tone. With the aid of His-bundle electrocardiography the block was localized in the av-node (AH).