Group beating bradycardia due to two level AV junctional conduction block including combined Wenckebach and Mobitz 2 fascicular block.

A case of a complex advanced two level AV junctional conduction block is described with electrocardiographic features consistent with the combination of incompletely concealed Wenckebach in the left anterior fascicle of the left bundle branch, and most probably in the right bundle branch and with Mobitz type II in the left posterior fascicle of the left bundle branch, resulting in intermittent trifascicular block.