Exercise Induced Atrioventricular Block in a Patient With Aortic Stenosis
Bibliographic record
Abstract
We present the case of a 62 years old gentleman with recurrent presyncopal episodes. During his first admission, an initial ECG revealed right bundle branch block and echocardiogram revealed moderate aortic stenosis, but no further precipitants were identified. A further episode prompted his readmission, and the patient requested to demonstrate symptoms whilst exercising. During exercise no symptoms were noted, but after a short period of rest, his symptoms appeared. ECG testing revealed second degree atrioventricular block (Mobitz type II), and a prolonged ventricular pause of almost six seconds. It is known that calcific aortic stenosis is associated with impaired atrioventricular node conduction, particularly when there is annular calcification. Whilst exercise testing is generally discouraged in symptomatic aortic stenosis, this case serves as a reminder that potentially treatable conduction disorders can be easily missed. Atrioventricular block should be considered when patients with aortic stenosis present with isolated presyncope. To our knowledge, this is the first case report to describe exercise induced transient AV node block in the presence of moderate to severe aortic stenosis. doi:10.4021/jmc464w
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.002 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".