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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
Observations on second degree atrioventricular block, including new criteria for the differential diagnosis between type I and type II block.
Langendorf R, Cohen H, Gozo EG Jr
Am J Cardiol 1972 Jan;29(1):111-9. doi: 10.1016/0002-9149(72)90426-2. PMID: 4550168

Recent clinical studies

Etiology

Risk of Cardiac Arrhythmias Among Climbers on Mount Everest.
Sherpa K, Sherpa PP, Sherpa T, Rothenbühler M, Ryffel C, Sherpa D, Sherpa DR, Sherchand O, Galuszka O, Dernektsi C, Reichlin T, Pilgrim T
JAMA Cardiol 2024 May 1;9(5):480-485. doi: 10.1001/jamacardio.2024.0364. PMID: 38568602Free PMC Article
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
Mobitz type I and II atrioventricular blocks during fingolimod therapy.
Saccà F, Puorro G, Marsili A, Pane C, Russo CV, Lanzillo R, de Rosa A, Cittadini A, De Angelis G, Brescia Morra V
Neurol Sci 2016 Sep;37(9):1557-9. Epub 2016 May 25 doi: 10.1007/s10072-016-2621-y. PMID: 27225279
Common questions about pacemakers.
Denay KL, Johansen M
Am Fam Physician 2014 Feb 15;89(4):279-82. PMID: 24695448
Second-degree AV block.
MacKenzie R
J Insur Med 2004;36(4):327-32. PMID: 15683211

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
Problematic definitions of Mobitz type II second degree AV block: Historical aspects.
Barold SS
J Electrocardiol 2023 Jul-Aug;79:122-123. Epub 2023 Apr 3 doi: 10.1016/j.jelectrocard.2023.03.086. PMID: 37084494
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
Second-degree atrioventricular block.
Palmer B, Carroll K
Medsurg Nurs 2014 Jul-Aug;23(4):261-3. PMID: 25318341
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

Therapy

Seeks, finds, threats: Lyme disease!
Muschart X, Blommaert D
Am J Emerg Med 2015 Feb;33(2):307.e5-6. Epub 2014 Jul 31 doi: 10.1016/j.ajem.2014.07.019. PMID: 25167973
Functional atrioventricular block in a preterm infant.
Al-Wahab S, Munyard P
Arch Dis Child Fetal Neonatal Ed 2001 Nov;85(3):F220-1. doi: 10.1136/fn.85.3.f220. PMID: 11668169Free PMC Article
ECG of the month. Nowhere to go. Second-degree AV block.
Martinez-Lopez JI
J La State Med Soc 2000 Jun;152(6):273-5. PMID: 10935363
Atrial flutter.
Olshaker JS
J Emerg Med 1988 Jan-Feb;6(1):55-9. doi: 10.1016/0736-4679(88)90252-1. PMID: 3283216
Second-degree atrioventricular block after methyl methacrylate.
Brown DL, Parmley CL
Anesthesiology 1982 May;56(5):391-2. doi: 10.1097/00000542-198205000-00013. PMID: 7073003

Prognosis

Risk of Cardiac Arrhythmias Among Climbers on Mount Everest.
Sherpa K, Sherpa PP, Sherpa T, Rothenbühler M, Ryffel C, Sherpa D, Sherpa DR, Sherchand O, Galuszka O, Dernektsi C, Reichlin T, Pilgrim T
JAMA Cardiol 2024 May 1;9(5):480-485. doi: 10.1001/jamacardio.2024.0364. PMID: 38568602Free PMC Article
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 AV block.
MacKenzie R
J Insur Med 2004;36(4):327-32. PMID: 15683211
Second-degree atrioventricular block.
Zipes DP
Circulation 1979 Sep;60(3):465-72. doi: 10.1161/01.cir.60.3.465. PMID: 378457
First- and second-degree A-V heart block with rapid eye movement sleep.
Nevins DB
Ann Intern Med 1972 Jun;76(6):981-3. doi: 10.7326/0003-4819-76-6-981. PMID: 4337481

Clinical prediction guides

Severe transient neonatal long QT syndrome due to maternal paroxetine usage: a case report.
Leerssen ECM, Tak RO, Breur JMPJ
Cardiol Young 2019 Oct;29(10):1300-1301. Epub 2019 Sep 2 doi: 10.1017/S1047951119001938. PMID: 31475669
Mobitz type I and II atrioventricular blocks during fingolimod therapy.
Saccà F, Puorro G, Marsili A, Pane C, Russo CV, Lanzillo R, de Rosa A, Cittadini A, De Angelis G, Brescia Morra V
Neurol Sci 2016 Sep;37(9):1557-9. Epub 2016 May 25 doi: 10.1007/s10072-016-2621-y. PMID: 27225279
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
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
Observations on second degree atrioventricular block, including new criteria for the differential diagnosis between type I and type II block.
Langendorf R, Cohen H, Gozo EG Jr
Am J Cardiol 1972 Jan;29(1):111-9. doi: 10.1016/0002-9149(72)90426-2. PMID: 4550168

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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