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An Indication for His Bundle Study: Syncope, a Normal P‐R Interval and a Narrow QRS

This report describes a patient who presented with transient central nervous system symptoms of unknown etiology with an electrocardiogram exhibiting a narrow QRS complex and normal P‐R interval. The decision to implant a permanent VVI pacemaker was made on the basis of a His bundle study that revealed significant prolongation of the HV interval. The successful clinical outcome re‐emphasizes the clinical usefulness of electrophysiologicol investigation in patients with syncope of undetermined etiology.