Paroxysmal atrioventricular block and right coronary artery stenosis without acute myocardial infarction.

Paroxysmal atrioventricular block is an ill-defined entity, previously described in sporadic cases in association with vasovagal reaction, coronary angiography and distal conduction disease. The occurrence of atrioventricular block in acute inferior wall myocardial infarction is related to the presence of an important right coronary artery that is occluded, the recanalisation of this vessel leads often to rapid regression of the block that is no longer pejorative. We present a case of paroxysmal atrioventricular block at monitor in a 44-year-old Italian man with right coronary artery stenosis and without acute myocardial infarction. Error in computer electrocardiogram interpretation was excluded. Coronary angiography revealed significant right coronary artery stenosis. Percutaneous transluminal coronary angioplasty with implantation of stent was successfully performed.