About-Cardio
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We provide our users the most up-to-date and accurate information on the treatment and prevention of cardio pathologies in accordance with current American and European clinical guidelines.
The information provided on this website is for educational purposes only and should not be considered medical advice. Always consult a licensed physician for diagnosis and treatment.
Understanding 2nd Degree AV Block on ECG
Introduction
Second-degree atrioventricular (AV) block is a conduction abnormality where some electrical impulses from the atria fail to reach the ventricles. This can lead to dropped beats, causing symptoms such as dizziness or syncope. On an electrocardiogram (ECG), second-degree AV block is categorized into two types: Mobitz type I (Wenckebach) and Mobitz type II.
Types of 2nd Degree AV Block
Mobitz Type I (Wenckebach)
- ECG Characteristics: Progressive prolongation of the PR interval until a beat is dropped.
- Clinical Significance: Often benign and can be caused by increased vagal tone or medications like beta-blockers or calcium channel blockers.
- Management: Usually does not require intervention unless symptomatic.
Mobitz Type II
- ECG Characteristics: Sudden dropped QRS complexes without progressive PR prolongation.
- Clinical Significance: More dangerous as it may progress to complete heart block.
- Management: Requires close monitoring and often pacemaker implantation.
Causes of 2nd Degree AV Block
- Medications (e.g., beta-blockers, digoxin)
- Ischemic heart disease
- Electrolyte imbalances
- Structural heart disease (e.g., myocarditis, amyloidosis)
Treatment and Management
- Asymptomatic Mobitz I: Monitor and correct reversible causes.
- Symptomatic Mobitz I or any Mobitz II: Consider pacemaker placement, especially if there is hemodynamic instability.
Always consult a cardiologist for proper evaluation and management.
Source recommendations
1. American Heart Association Guidelines on Bradycardia and Conduction Disorders
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia/conduction-disorders
- https://www.ahajournals.org/doi/10.1161/CIR.0000000000000628
- https://www.heart.org/en/health-topics/arrhythmia/about-arrhythmia
- https://pubmed.ncbi.nlm.nih.gov/30412709/
- https://www.jacc.org/guidelines/bradycardia
2. European Society of Cardiology Guidelines on Cardiac Pacing and Resynchronization Therapy
- https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Cardiac-Pacing-and-Cardiac-Resynchronization-Therapy
- https://academic.oup.com/eurheartj/article/42/35/3427/6358547
- https://pubmed.ncbi.nlm.nih.gov/34455430/
- https://academic.oup.com/eurheartj/article/34/29/2281/401445
- https://pubmed.ncbi.nlm.nih.gov/23801827/
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If you or your loved ones experience any of these symptoms, you should consult a doctor in time. Remember that self-medication can be dangerous, and timely diagnosis will preserve the quality and life expectancy.
The heart is an organ that does not know how to "keep silent" if something goes wrong. Chest pain, shortness of breath, swelling, dizziness, and rhythm disturbances are the symptoms that require our attention. The best prevention of heart disease is careful attention to your health, regular checkups with a doctor, and a healthy lifestyle. Take care of your heart, and it will serve you for many years!
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