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AV Block Second Degree by ECG Finding

MedGen UID:
811441
•Concept ID:
C3714697
•
Finding
Synonyms: AV Block Second Degree; AV Block Second Degree by EKG Finding; Intermittent AV Block; Second Degree Atrioventricular Block; Second Degree AV Block

Definition

An electrocardiographic finding of intermittent failure of atrial electrical impulse conduction to the ventricles. This is manifest on the ECG by regular P waves which intermittently are not followed by QRS complexes. (CDISC) [from NCI]

Professional guidelines

PubMed

Association between Atrioventricular Block and Mortality in Primary Care Patients: The CODE Study.
Paixão GMM, Lima EM, Quadros AB, Cabral DPR, Coelho RR, Oliveira DM, Nascimento JS, Gomes PR, Ribeiro AL
Arq Bras Cardiol 2022 Oct;119(4):564-571. doi: 10.36660/abc.20210763. PMID: 35857946Free PMC Article
Evaluation and management of atrioventricular block in children.
Saleh F, Greene EA, Mathison D
Curr Opin Pediatr 2014 Jun;26(3):279-85. doi: 10.1097/MOP.0000000000000100. PMID: 24759228
Clinical features and management of digitalis poisoning--rationale for immunotherapy.
Taboulet P, Baud FJ, Bismuth C
J Toxicol Clin Toxicol 1993;31(2):247-60. doi: 10.3109/15563659309000392. PMID: 8492338

Recent clinical studies

Etiology

Obesity and Cardiac Conduction Block Disease in China.
Liu P, Wang Y, Zhang X, Zhang Z, Zhao N, Ou W, Wang G, Yang X, Li M, Zhang Y, Yang X, Wu S
JAMA Netw Open 2023 Nov 1;6(11):e2342831. doi: 10.1001/jamanetworkopen.2023.42831. PMID: 37955899Free PMC Article
Long-Term Follow-Up of Second-Degree Heart Block in Children.
Epstein R, Liberman L, Silver ES
Pediatr Cardiol 2023 Oct;44(7):1529-1535. Epub 2023 Sep 1 doi: 10.1007/s00246-023-03195-w. PMID: 37658175
Assessment of atrioventricular conduction by echocardiography and magnetocardiography in normal and anti-Ro/SSA-antibody-positive pregnancies.
Cuneo BF, Bitant S, Strasburger JF, Kaizer AM, Wakai RT
Ultrasound Obstet Gynecol 2019 Nov;54(5):625-633. doi: 10.1002/uog.20245. PMID: 30784137Free PMC Article
Common questions about pacemakers.
Denay KL, Johansen M
Am Fam Physician 2014 Feb 15;89(4):279-82. PMID: 24695448
ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance.
Zehender M, Meinertz T, Keul J, Just H
Am Heart J 1990 Jun;119(6):1378-91. doi: 10.1016/s0002-8703(05)80189-9. PMID: 2191578

Diagnosis

Definitions and Pitfalls in the Diagnosis of Atrioventricular Block.
Barold SS
Heart Lung Circ 2023 Dec;32(12):1413-1416. Epub 2023 Nov 3 doi: 10.1016/j.hlc.2023.09.018. PMID: 37926640
Electrocardiography of Atrioventricular Block.
Clark BA, Prystowsky EN
Cardiol Clin 2023 Aug;41(3):307-313. doi: 10.1016/j.ccl.2023.03.007. PMID: 37321683
Electrocardiography of Atrioventricular Block.
Clark BA, Prystowsky EN
Card Electrophysiol Clin 2021 Dec;13(4):599-605. Epub 2021 Sep 25 doi: 10.1016/j.ccep.2021.07.001. PMID: 34689889
Vagally mediated atrioventricular block: pathophysiology and diagnosis.
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970
Second-degree atrioventricular block revisited.
Barold SS, Herweg B
Herzschrittmacherther Elektrophysiol 2012 Dec;23(4):296-304. Epub 2012 Dec 7 doi: 10.1007/s00399-012-0240-8. PMID: 23224264

Therapy

Cardiac involvement in Wilson's disease: a retrospective cohort study.
Wang C, Gao H, Sun J, Wang L, Li W, Zu X, Cheng P, Wei S, Zhao P
Eur J Gastroenterol Hepatol 2022 Nov 1;34(11):1147-1150. Epub 2022 Aug 23 doi: 10.1097/MEG.0000000000002432. [Epub ahead of print] PMID: 36170683
Advanced Heart Block in Children with Lyme Disease.
Bolourchi M, Silver ES, Liberman L
Pediatr Cardiol 2019 Mar;40(3):513-517. Epub 2018 Oct 31 doi: 10.1007/s00246-018-2003-8. PMID: 30377753
Benzodiazepine-associated atrioventricular block.
Arroyo Plasencia AM, Ballentine LM, Mowry JB, Kao LW
Am J Ther 2012 Jan;19(1):e48-52. doi: 10.1097/MJT.0b013e3181dcf572. PMID: 20535011
Woldemar Mobitz and His 1924 classification of second-degree atrioventricular block.
Silverman ME, Upshaw CB Jr, Lange HW
Circulation 2004 Aug 31;110(9):1162-7. doi: 10.1161/01.CIR.0000140669.35049.34. PMID: 15339865
Atrial flutter.
Olshaker JS
J Emerg Med 1988 Jan-Feb;6(1):55-9. doi: 10.1016/0736-4679(88)90252-1. PMID: 3283216

Prognosis

Long-Term Follow-Up of Second-Degree Heart Block in Children.
Epstein R, Liberman L, Silver ES
Pediatr Cardiol 2023 Oct;44(7):1529-1535. Epub 2023 Sep 1 doi: 10.1007/s00246-023-03195-w. PMID: 37658175
Diagnostic and Prognostic Implications of Surface Recordings from Patients with Atrioventricular Block.
Nelson WP
Card Electrophysiol Clin 2016 Mar;8(1):25-35. doi: 10.1016/j.ccep.2015.10.031. PMID: 26920166
Evaluation and management of atrioventricular block in children.
Saleh F, Greene EA, Mathison D
Curr Opin Pediatr 2014 Jun;26(3):279-85. doi: 10.1097/MOP.0000000000000100. PMID: 24759228
Vagally mediated atrioventricular block: pathophysiology and diagnosis.
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970
Second-degree atrioventricular block.
Zipes DP
Circulation 1979 Sep;60(3):465-72. doi: 10.1161/01.cir.60.3.465. PMID: 378457

Clinical prediction guides

Electrocardiographic features of paradoxical ventriculophasic response.
Nakashima T, Nagase M, Shibahara T, Ono D, Yamada T, Tanabe G, Suzuki K, Yamaura M, Ido T, Takahashi S, Okura H, Aoyama T
J Electrocardiol 2022 Mar-Apr;71:67-73. Epub 2022 Feb 12 doi: 10.1016/j.jelectrocard.2022.02.002. PMID: 35183045
A Heart too Drunk to Drive; AV Block following Acute Alcohol Intoxication.
van Stigt AH, Overduin RJ, Staats LC, Loen V, van der Heyden MA
Chin J Physiol 2016 Feb 29;59(1):1-8. doi: 10.4077/CJP.2016.BAE364. PMID: 26875557
Vagally mediated atrioventricular block: pathophysiology and diagnosis.
Alboni P, Holz A, Brignole M
Heart 2013 Jul;99(13):904-8. Epub 2013 Jan 2 doi: 10.1136/heartjnl-2012-303220. PMID: 23286970
Arrhythmias in centenarians.
Wakida Y, Okamoto Y, Iwa T, Yonemoto T, Kanemaki K, Shiomi T, Mizutani K, Kobayashi T
Pacing Clin Electrophysiol 1994 Nov;17(11 Pt 2):2217-21. doi: 10.1111/j.1540-8159.1994.tb03829.x. PMID: 7845846
ECG variants and cardiac arrhythmias in athletes: clinical relevance and prognostic importance.
Zehender M, Meinertz T, Keul J, Just H
Am Heart J 1990 Jun;119(6):1378-91. doi: 10.1016/s0002-8703(05)80189-9. PMID: 2191578

Recent systematic reviews

Permanent Left Bundle Branch Area Pacing for High-Degree Atrioventricular Block in a 6-Year-Old Child with 2-Year Follow-Up.
Hua J, Xiong Q, Xia Z, Huang Q, Huang L, Xia Z, Hu J, Li J, Hu J, Chen Q, Hong K
Int Heart J 2022 Sep 30;63(5):957-962. Epub 2022 Sep 14 doi: 10.1536/ihj.22-103. PMID: 36104231
Predictors of Permanent Pacemaker Implantation in Patients Undergoing Transcatheter Aortic Valve Replacement - A Systematic Review and Meta-Analysis.
Ullah W, Zahid S, Zaidi SR, Sarvepalli D, Haq S, Roomi S, Mukhtar M, Khan MA, Gowda SN, Ruggiero N, Vishnevsky A, Fischman DL
J Am Heart Assoc 2021 Jul 20;10(14):e020906. Epub 2021 Jul 14 doi: 10.1161/JAHA.121.020906. PMID: 34259045Free PMC Article

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