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A-V Blocks

Dr Swapnil Pawar December 23, 2021 16


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    A-V Blocks
    Dr Swapnil Pawar

Atrioventricular Blocks

Written by Dr Andrew Lam

First Degree Heart Block 

  • Prolongation of the PR interval (>200ms)
  • Benign as an isolated entity that doesn’t cause haemodynamic instability. Intervention generally not required

Second Degree Heart Block (Mobitz Type 1 – Wenckebach)

  • Progressive prolongation of the PR interval, followed by non-conductive p-wave
  • Usually benign, low risk of haemodynamic instability or progression to complete heart block 
  • Rarely require pacemaker insertion and asymptomatic patients don’t require intervention

Second Degree Heart Block (Mobitz Type 2)

  • Consistent PR interval followed by sudden “dropped beat” with failure to conduct p-wave
  • Higher risk of haemodynamic instability, asystole and progression to complete heart block
  • Usually requires admission for cardiac monitoring and pacemaker insertion.

Third Degree (Complete) Heart Block

  • Complete AV dissociation (no relationship between p-waves and QRS complexes)
  • At risk of sudden cardiac death and ventricular standstill
  • Require admission for cardiac monitoring and pacemaker insertion

References: 

Nickson, C. (2020). Heart Block and Conduction Abnormalities, Life in the Fast Lane. Retrieved 23rd November 2021 from https://litfl.com/heart-block-and-conduction-abnormalities/

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