Concealed Paroxysmal Atrioventricular Block: Diffuse Congenital Atrioventricular Conduction System Disorder with Nonpropagated His Bundle Depolarizations

A 2 1/2‐year‐old girl with bradycardia and left bundle branch block at birth began to experience “night cries” when deeply asleep. Electrophysiological study demonstrated congenital diffuse atrioventricular conduction disease with concealed paroxysmal atrioventricular block, nonpropagated His bundle depolarizations, severe sinus node abnormality, and a low atrioventricular junctional escape rhythm with probable reciprocation. After pacemaker implant, the “night cries” ceased.