This report discusses a case of transient 2:1 atrioventricular block with conduction system pacing 4 hours after leadless right ventricular pacemaker implantation in a 19-year-old patient with a history of cardioinhibitory syncope and asystole cardiac arrest but without preexisting atrioventricular block. The atrioventricular block was resolved spontaneously. Pacing morphology was suggestive of right bundle branch pacing. Neither 2:1 atrioventricular block nor conduction system pacing has previously been a reported outcome of right ventricular leadless pacemaker implantation. The report demonstrates that conduction system pacing with leadless devices is achievable. Further study of techniques, limitations, and complications related to intentional right ventricular leadless conduction system pacing is warranted.

本报告讨论了一名 19 岁患者植入无引线右心室起搏器 4 小时后出现短暂 2:1 房室传导阻滞的病例，该患者有心抑制性晕厥和心搏停止性心脏骤停病史，但没有既往存在房室传导阻滞。房室传导阻滞自行缓解。起搏形态提示右束支起搏。 2:1 房室传导阻滞和传导系统起搏之前都没有报道过右心室无引线起搏器植入的结果。该报告表明，利用无引线设备进行传导系统起搏是可以实现的。有必要进一步研究与有意右心室无引线传导系统起搏相关的技术、局限性和并发症。