AV block refers to abnormalities in conduction between the atria and ventricles. There are several types of AV block including first degree, Mobitz types I and II second-degree, advanced, paroxysmal, third-degree complete heart block, and vagal AV block. Mobitz types I and II second-degree blocks differ in their PR interval patterns and responses to exercise and carotid massage. Third-degree complete heart block shows dissociation between the atrial and ventricular rates.
AV block refers to abnormalities in conduction between the atria and ventricles. There are several types of AV block including first degree, Mobitz types I and II second-degree, advanced, paroxysmal, third-degree complete heart block, and vagal AV block. Mobitz types I and II second-degree blocks differ in their PR interval patterns and responses to exercise and carotid massage. Third-degree complete heart block shows dissociation between the atrial and ventricular rates.
AV block refers to abnormalities in conduction between the atria and ventricles. There are several types of AV block including first degree, Mobitz types I and II second-degree, advanced, paroxysmal, third-degree complete heart block, and vagal AV block. Mobitz types I and II second-degree blocks differ in their PR interval patterns and responses to exercise and carotid massage. Third-degree complete heart block shows dissociation between the atrial and ventricular rates.
AV block refers to abnormalities in conduction between the atria and ventricles. There are several types of AV block including first degree, Mobitz types I and II second-degree, advanced, paroxysmal, third-degree complete heart block, and vagal AV block. Mobitz types I and II second-degree blocks differ in their PR interval patterns and responses to exercise and carotid massage. Third-degree complete heart block shows dissociation between the atrial and ventricular rates.
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AV Block
AV block refers to conduction system abnormalities between the atrium and the ventricle.
Broadly AV blocks are of the following types:
1st degree AV block: PR interval is prolonged to more than 200 msec (normal PR interval 120- 200msec) due to slowing of conduction in the conduction system.
2nd-degree AV block is an intermittent conduction loss between the atria and ventricles. It is of the following types.
Mobitz type I block: In this form of AV block, the PR interval gradually increases with the shortening of the RR interval before the block. This results in the grouping of beats. This phenomenon is also called as Wenckebach phenomenon. It generally suggests a problem in the AV node (supra-hisian conduction system).
Mobitz type II block: The PR does not increase before the block. The PR interval remains the same before and after the block. This generally suggests a problem in the infra-hisian conduction system.
Mobitz I AV block Mobitz II AV block
PR interval variation Progressively increases Constant RR interval shortening Present Absent QRS Generally Narrow Wide Response to carotid massage Conduction worsens Conduction improves Response to Exercise Conduction improves Conduction worsens Location of pathology AV node Infra hisian
Advanced AV block: Also called a High-grade AV block: In these more than 2 consecutive P waves are blocked. It has a high risk of progression to complete heart block. Paroxysmal AV block: The AV block occurs abruptly, generally preceded by an ectopic beat. Generally, there would be signs of pre-existing conduction disturbances like a bundle branch block or a fascicular block. AV conduction resumes following an escape beat or by another ectopic beat.
3rd degree AV block: Also called Complete Heart Block. Complete loss of conduction between atria and ventricles. So, both atria (P wave) and ventricle (R wave) are dissociated.
The diagnosis of CHB should be made when the ECG shows
Varying PR interval Regular PP interval (sinus interval) Regular RR interval (escape interval) The atrial rate should fast than the ventricular rate (all 4 criteria should be satisfied)
Vagal AV block: In this, Sinus rates slow down, and PR interval gradually increases before AV block. Commonly seen during sleep, athletic individuals with high vagal tone.
