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Mobitz type II second-degree atrioventricular block during sleep: true or false?

S Serge Barold¹

¹School of Medicine and Dentistry, University of Rochester, Rochester, NY, USA. ssbarold@aol.com.

Herzschrittmachertherapie & Elektrophysiologie

|August 4, 2023

Summary

The existence of Mobitz type II second-degree atrioventricular block during sleep apnea is questionable. Previous studies lack clear definitions and electrocardiogram evidence, casting doubt on its occurrence during sleep.

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Area of Science:

Cardiology
Sleep Medicine
Electrophysiology

Background:

Previous publications suggest a link between sleep apnea and Mobitz type II second-degree atrioventricular (AV) block.
However, these reports often lack precise diagnostic criteria and supporting electrocardiogram (ECG) evidence.

Purpose of the Study:

To critically evaluate the evidence supporting the occurrence of Mobitz type II second-degree AV block during sleep apnea.
To highlight the diagnostic ambiguities and limitations in existing literature.

Main Methods:

Review of existing literature on Mobitz type II AV block and sleep apnea.
Analysis of the definitions and diagnostic criteria used in reported cases.
Assessment of the quality and completeness of ECG evidence provided in previous studies.

Keywords:

Electrocardiogram Heart block Sleep Sleep apnea Vagal tone Wenckebach block

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Main Results:

A significant lack of standardized definitions for Mobitz type II AV block in the context of sleep apnea was observed.
Representative electrocardiograms confirming the diagnosis during sleep were generally absent in the reviewed publications.
The evidence presented is insufficient to definitively establish the occurrence of Mobitz type II AV block during sleep.

Conclusions:

The claim that Mobitz type II second-degree AV block occurs during sleep apnea remains unsubstantiated due to methodological and evidential limitations.
Further rigorous studies with clear definitions and comprehensive ECG documentation are required to investigate this association.
The clinical significance and prevalence of Mobitz type II AV block during sleep require re-evaluation.