Type I Wenckebach second-degree AV block: A matter of definition

The diagnosis of first-degree and third-degree atrioventricular (AV) block is straightforward but that of second-degree AV block is more involved. Type I block and type II second-degree AV block are electrocardiographic patterns that refer to the behaviour of the PR intervals (in sinus rhythm) in sequences (with at least two consecutive conducted PR intervals) where a single P wave fails to conduct to the ventricles. Type I second-degree AV block describes visible, differing, and generally decremental AV conduction. Type II second-degree AV block describes what appears to be an all-or-none conduction without visible changes in the AV conduction time before and after the blocked impulse. The diagnosis of type II block requires a stable sinus rate, an important criterion because a vagal surge (generally benign) can cause simultaneous sinus slowing and AV nodal block, which can resemble type II block. The diagnosis of type II block cannot be established if the first post-block P wave is followed by a shortened PR interval or by an undiscernible P wave. A narrow QRS type I block is almost always AV nodal, whereas a type I block with bundle branch block barring acute myocardial infarction is infranodal in 60–70% of cases. All correctly defined type II blocks are infranodal. A 2:1 AV block cannot be classified in terms of type I or type II block, but it can be AV nodal or infranodal. Concealed His bundle or ventricular extrasystoles may mimic both type I or type II block (pseudo-AV block), or both

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Type I Second-Degree AV Block (Mobitz Type I, Wenckebach AV Block) During Ritrodrine Therapy for Preterm Labor

American Journal of Perinatology ◽

10.1055/s-2007-999365 ◽

1991 ◽

Vol 8 (02) ◽

pp. 150-152 ◽

Cited By ~ 2

Author(s):

David Sherer ◽

Mark Nawrocki ◽

Howard Thompson ◽

James Woods

Keyword(s):

Preterm Labor ◽

Type I ◽

Av Block ◽

Mobitz Type ◽

Second Degree

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A Case of Lyme Carditis Presenting with Atrial Fibrillation

Case Reports in Cardiology ◽

10.1155/2018/5265298 ◽

2018 ◽

Vol 2018 ◽

pp. 1-5 ◽

Cited By ~ 2

Author(s):

Peter J. Kennel ◽

Melvin Parasram ◽

Daniel Lu ◽

Diane Zisa ◽

Samuel Chung ◽

...

Keyword(s):

Atrial Fibrillation ◽

Borrelia Burgdorferi ◽

Antibiotic Therapy ◽

Unusual Presentation ◽

Type I ◽

Atrial Arrhythmias ◽

Av Block ◽

Lyme Carditis ◽

Second Degree

We report a case of a 20-year-old man who presented to our institution with a new arrhythmia on a routine EKG. Serial EKG tracings revealed various abnormal rhythms such as episodes of atrial fibrillation, profound first degree AV block, and type I second degree AV block. He was found to have positive serologies for Borrelia burgdorferi. After initiation of antibiotic therapy, the atrial arrhythmias and AV block resolved. Here, we present a case of Lyme carditis presenting with atrial fibrillation, a highly unusual presentation of Lyme carditis.

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Atrioventricular conduction abnormalities and atrioventricular blocks: ECG patterns and diagnosis

ESC CardioMed ◽

10.1093/med/9780198784906.003.0453_update_001 ◽

2018 ◽

pp. 1958-1961

Author(s):

S. Serge Barold

Keyword(s):

P Wave ◽

Conduction Time ◽

Type I ◽

Type Ii ◽

Av Block ◽

Ventricular Extrasystoles ◽

Av Conduction ◽

Pr Interval ◽

Before And After ◽

Second Degree

The diagnosis of first-degree and third-degree atrioventricular (AV) block is straightforward but that of second-degree AV block is more involved. Type I block and type II second-degree AV block are electrocardiographic patterns that refer to the behaviour of the PR intervals (in sinus rhythm) in sequences (with at least two consecutive conducted PR intervals) where a single P wave fails to conduct to the ventricles. Type I second-degree AV block describes visible, differing, and generally decremental AV conduction. Type II second-degree AV block describes what appears to be an all-or-none conduction without visible changes in the AV conduction time before and after the blocked impulse. The diagnosis of type II block requires a stable sinus rate, an important criterion because a vagal surge (generally benign) can cause simultaneous sinus slowing and AV nodal block, which can resemble type II block. The diagnosis of type II block cannot be established if the first post-block P wave is followed by a shortened PR interval or by an undiscernible P wave. A narrow QRS type I block is almost always AV nodal, whereas a type I block with bundle branch block barring acute myocardial infarction is infranodal in 60–70% of cases. All correctly defined type II blocks are infranodal. A 2:1 AV block cannot be classified in terms of type I or type II block, but it can be AV nodal or infranodal. Concealed His bundle or ventricular extrasystoles may mimic both type I or type II block (pseudo-AV block), or both

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AV Block Second Degree Mobitz Type I

10.32388/q310ml ◽

2020 ◽

Author(s):

Keyword(s):

Type I ◽

Av Block ◽

Mobitz Type ◽

Second Degree

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Implantable loop recorder follow-up

European Heart Journal ◽

10.1093/eurheartj/ehab724.0318 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

J Pena Mellado ◽

R Macias ◽

L Tercedor ◽

M Alvarez Lopez

Keyword(s):

Head Trauma ◽

Type I ◽

Av Block ◽

Implantable Loop Recorder ◽

Ecg Monitoring ◽

Loop Recorder ◽

Tertiary Center ◽

Unexplained Syncope ◽

Baseline Characteristics

Abstract Introduction Long ambulatory ECG monitoring can be a useful component in the evaluation of the patient with unexplained syncope or syncope with suspected arrhythmic origin, as well as a sensitive tool for detecting asymptomatic spontaneous cardiac arrhythmias or conduction abnormalities in predisposed patients. Purpose To determine the diagnostic cost-effectiveness of the implantable loop recorder (ILR) in the origin of unexplained syncope in our center. Methods A retrospective observational study was carried out in a tertiary center, those patients with an ILR between August 2014 and March 2021 were included. Baseline characteristics of the population and their previous ECG, arrythmias detected during follow-up and pacemaker implant rate were evaluated. Results One hundred twenty-seven patients with a ILR were included (age 67 years, 49.6% males). Most often cause of ILR was unexplained syncope (90.6%) followed by monitoring after TAVI implant (3.9%). Normal LVEF (>50%) was present in 85.6%,and 75.6% had NYHA I functional class. 118 patients (92.9%) presented sinus rhythm at implant time, and 8 (6.3%) presented AF. 12.6% presented first degree atrioventricular (AV) block, 2 patients (1.6%) had presented previously Mobitz Type I AV block and one patient 2:1 block. Left bundle branch block (LBBB) was present in 13.4%,RBBB in 3.1%,LAFB in 9.4%, RBBB+LAFB in 11% and RBBB+LPFB in 2.4%. Median time of follow-up was 21 months. 3rd degree AV block was the most frequent arrhythmia detected (12.1%), followed by >3s pause (8%) and previously unknown AF (2.4%).The patients with syncope who suffered head trauma (33%) presented a higher rate of pacemaker (PCM) implant compared to those without head trauma: 31.6% vs 14.7%. In total,19.8% PCM rate implant during follow-up. No complications ILR related. Conclusion In conclusion, long home ECG monitoring with ILR is a powerful and helpful tool to find out or rule out potentially dangerous arrhythmias as cause of syncope, with no complications in our experience. FUNDunding Acknowledgement Type of funding sources: None. Baseline characteristics Arrhythmias detected during follow-up

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PACE BEFORE IT'S TOO LATE! SECOND DEGREE AV BLOCK WITH RBBB AND LAFB

Journal of the American College of Cardiology ◽

10.1016/s0735-1097(18)33160-7 ◽

2018 ◽

Vol 71 (11) ◽

pp. A2619

Author(s):

Fuad Habash ◽

Aisha Siraj ◽

Venusa Phomakay ◽

Hakan Paydak

Keyword(s):

Av Block ◽

Second Degree

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Vagally Induced Second Degree A-V Block Mobitz Type I, and the Hyporeactive SA Node

CHEST Journal ◽

10.1378/chest.62.2.152 ◽

1972 ◽

Vol 62 (2) ◽

pp. 152-155 ◽

Cited By ~ 20

Author(s):

Miguel Gambetta ◽

Pablo Denes ◽

Roderick W. Childers

Keyword(s):

Type I ◽

Sa Node ◽

Mobitz Type ◽

Second Degree

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2:1 Atrioventricular Conduction due to Congenital Long QT Syndrome

Indian Journal of Cardiovascular Disease in Women WINCARS ◽

10.1055/s-0037-1606851 ◽

2017 ◽

Vol 02 (03) ◽

pp. 054-055

Author(s):

Maneesh Rai ◽

Soma Ghanta

Keyword(s):

Long Qt Syndrome ◽

Refractory Period ◽

Poor Prognosis ◽

Atrioventricular Conduction ◽

Av Block ◽

Long Qt ◽

Uncommon Presentation ◽

Qt Syndrome ◽

Congenital Long Qt Syndrome ◽

Second Degree

AbstractLong QT syndrome patients can present as second-degree AV block due to prolongation of refractory period. We report a case of pseudo 2:1 AV block due to long QT syndrome in which treatment differs from conventional second-degree AV block because of uncommon presentation and poor prognosis with no consensus.

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