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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

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
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
Common questions about pacemakers.
Denay KL, Johansen M
Am Fam Physician 2014 Feb 15;89(4):279-82. PMID: 24695448
The effect of hyperkalaemia on cardiac rhythm devices.
Barold SS, Herweg B
Europace 2014 Apr;16(4):467-76. Epub 2014 Jan 23 doi: 10.1093/europace/eut383. PMID: 24465006

Diagnosis

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
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
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

Arrhythmias in Patients on Maintenance Dialysis: A Cross-sectional Study.
Rantanen JM, Riahi S, Schmidt EB, Johansen MB, Søgaard P, Christensen JH
Am J Kidney Dis 2020 Feb;75(2):214-224. Epub 2019 Sep 18 doi: 10.1053/j.ajkd.2019.06.012. PMID: 31542235
Comfrey herbal remedy causing second-degree heart block: do not be outfoxed by digitalis.
Vithayathil MK, Edwards M
BMJ Case Rep 2016 Dec 1;2016 doi: 10.1136/bcr-2016-216995. PMID: 27908913Free PMC Article
Second-Degree Atrioventricular Block Occurring After Tooth Extraction.
Kamatani T, Akizuki A, Kondo S, Shirota T
Anesth Prog 2016 Fall;63(3):156-9. doi: 10.2344/15-00042.1. PMID: 27585419Free PMC Article
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
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

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
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
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
The effect of hyperkalaemia on cardiac rhythm devices.
Barold SS, Herweg B
Europace 2014 Apr;16(4):467-76. Epub 2014 Jan 23 doi: 10.1093/europace/eut383. PMID: 24465006
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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