Mobitz type II block without bundle-branch block.

His bundle (H) electrograms were recorded in three patients with Mobitz type II block and narrow QRS. Block was secondary to digitalis intoxication in one patient. In the second patient, who had first-degree A-V block, type II block occurred with atrial pacing at a slightly increased heart rate. In the third patient, who had corrected transposition of the great vessels, type II block occurred spontaneously. In two additional patients, block simulating type II block was noted. In one, block of single P waves occurred with carotid massage. In the other, Wenckebach periods with small increments in P-R (and P-H) intervals resembled episodes of type II block. In all five patients, block was proximal to H, suggesting the A-V node as the site of block. The conduction defects in these patients were not progressive; none of the patients needed