Overview
Heart block refers to impaired conduction of electrical impulses through the atrioventricular conduction system.
It ranges from mild PR prolongation to complete dissociation between atrial and ventricular activity.
Types
First-degree AV block causes PR prolongation. Second-degree block includes Mobitz I and Mobitz II patterns, while third-degree block produces complete AV dissociation.
Clinical Features
Patients may be asymptomatic or develop fatigue, dizziness, presyncope, syncope, or hemodynamic compromise.
High-grade AV block with symptoms or hemodynamic instability requires urgent specialist management.
Investigation & Management
ECG establishes the conduction pattern. Continuous monitoring may be needed for intermittent or high-grade block.
Treatment depends on the type, cause, symptoms, and hemodynamic effect and may require temporary or permanent pacing.
Clinical Pearls
The severity of AV block is determined by how reliably atrial impulses reach the ventricles.
END OF REVIEW
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