ArticleJACC. Case reports2026
PR Interval Alternans and the Mystery of Inverse Decremental Conduction.
Article in JACC. Case reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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5 authors.
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Abstract
case summaryA 73-year-old man with severe aortic stenosis and preexisting right bundle branch block (RBBB) underwent transcatheter aortic valve replacement. Postprocedural day 4 mobile cardiac outpatient telemetry revealed intermittent atrioventricular block. A 12-lead electrocardiogram obtained in the emergency department revealed PR interval alternans with RBBB, with longer PR following longer preceding RP intervals, and shorter PR following shorter RP intervals. He suddenly experienced cardiac arrest due to proximal atrioventricular block, requiring cardiopulmonary resuscitation. TAKE-HOME MESSAGES: Inverse decremental conduction, known as Yan conduction, demonstrates an inverse relationship between conduction time and frequency of upstream stimulation. Inverse decremental conduction within the left bundle branch in the setting of RBBB may manifest as PR alternans, heralding proximal atrioventricular block.
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