Related Experiment Videos
Is Mobitz type I atrioventricular block benign in adults?
D B Shaw1, J I Gowers, C A Kekwick
1Cardiac Department, Royal Devon and Exeter Hospital, Exeter, UK. davbar66@btopenworld.com
Heart (British Cardiac Society)
|January 20, 2004
Summary
Chronic Mobitz I block is serious in adults over 45. Pacemaker implantation improves survival, even without symptoms or heart disease. This study highlights the need for proactive pacing in this patient group.
Area of Science:
- Cardiology
- Electrophysiology
- Internal Medicine
Background:
- Chronic Mobitz type I second degree atrioventricular block (Mobitz I) can affect adults.
- The necessity of pacemaker implantation in these patients requires further investigation.
Purpose of the Study:
- To evaluate the indications and outcomes of pacemaker implantation in adults with chronic Mobitz I block.
- To assess the survival rates and adverse events in paced versus unpaced patients.
Main Methods:
- A prospective study was conducted at a district general hospital involving 147 adult subjects with chronic Mobitz I block.
- Patients were followed up to assess outcomes including death, conduction deterioration, and symptomatic bradycardia.
- Pacemakers were implanted in 90 patients, primarily for symptoms (74) and prophylaxis (16).
Main Results:
- Five-year survival was significantly reduced in unpaced patients compared to the normal population.
- Paced patients demonstrated improved survival rates compared to unpaced patients, particularly those with organic heart disease.
- Survival rates were notably lower in patients aged 45 and above, with only the younger cohort and those with sinus arrhythmia showing over 50% survival.
Conclusions:
- Chronic Mobitz I block is generally not benign in patients aged 45 years and older.
- Pacemaker implantation should be considered even in the absence of symptomatic bradycardia or organic heart disease.
- This suggests a more aggressive approach to pacing may be warranted for selected patients with Mobitz I block.