Intra-His bundle block in 2:1 atrioventricular block
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Introduction:
Catheter stability is very important for achieving a precise electrophysiological study (EPS); 2:1 atrioventricular (AV) block is usually a disease of various levels such as supra-, intra- and infra-hisian. We report a case with some confusion caused by the instability of the catheter used for the His-electrogram recording during 2:1 AV block due to an intra-hisian block.

Case Report
A 77-year-old female complained of dizziness. Her past history had hypertension, and had been taking dihydrophyridine calcium channel blockers for 10 years. The chest radiograph showed cardiomegaly. The echocardiography revealed a normal function and wall motion. A resting electrocardiogram (ECG) revealed 2:1 AV block and right bundle branch block. After an intravenous injection of atropine and an exercise treadmill test, the ECG exhibited persistent 2:1 AV block.....

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4620082/
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