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Related Experiment Videos

Second-degree atrioventricular block: Mobitz type II

J M Wogan1, S R Lowenstein, G S Gordon

  • 1Department of Emergency Medicine, Johns Hopkins Hospital, Johns Hopkins University School of Medicine, Baltimore, Maryland.

The Journal of Emergency Medicine
|January 1, 1993
PubMed
Summary
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Second-degree atrioventricular (AV) block, often seen in myocardial infarction, can be further classified by block location. Mobitz type II AV block carries a higher risk of progressing to complete heart block.

Area of Science:

  • Cardiology
  • Electrophysiology

Background:

  • Atrioventricular (AV) block is a frequent complication of myocardial infarction and a manifestation of conduction system disease.
  • Other causes include drug toxicity, electrolyte imbalances, and inflammatory or infiltrative cardiomyopathies.
  • Second-degree AV block, or incomplete heart block, involves intermittent failure of atrial impulse conduction to the ventricles.

Purpose of the Study:

  • To differentiate between Mobitz type I and Mobitz type II second-degree AV block based on anatomical site and prognosis.
  • To emphasize the clinical significance of determining the location of the AV block (intranodal vs. infranodal).
  • To highlight the potential for progression to complete heart block and Stokes-Adams arrest in type II AV block.

Main Methods:

  • Utilizing patient age, clinical context, and QRS complex width on surface electrocardiography to ascertain the site of AV block.

Related Experiment Videos

  • Distinguishing second-degree AV block from other causes of cardiac pauses, such as nonconducted premature atrial contractions and atrial tachycardia with block.

    • Main Results:

    • Mobitz type II block is typically infranodal, while Mobitz type I block is usually intranodal.
    • Type II AV block demonstrates a greater likelihood of progressing to complete heart block and associated risks.
    • Accurate localization of the block is achievable in most second-degree AV block cases, including 2:1 conduction.

    Conclusions:

    • The anatomical site of second-degree AV block is crucial for clinical management and prognosis.
    • Mobitz type II AV block requires careful monitoring due to its higher risk of progression.
    • Differentiating AV block from other pause-inducing arrhythmias is essential for appropriate diagnosis and treatment.