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Encyclopedia > Mobitz I

Second degree heart block is a disease of the electrical conduction system of the heart.


If this term is used without a qualifier, it is usually assumed to be regarding disease of the atrioventricular node (AV node). However it is possible to have a second degree heart block involving the sinoatrial node (SA node) as well.


There are two distinct types of second degree heart block, called type 1 and type 2. The distinction is made between them because type 1 second degree heart block is considered a more benign entity than type 2 second degree heart block.


Type 1 Second degree heart block

Type 1 Second degree heart block, also known as Mobitz I heart block or Wenckebach phenomenon, is a disease of the AV node.


Mobitz I heart block is characterized by progressive prolongation of the PR interval on the electrocardiogram (EKG) on consecutive beats followed by a blocked beat (dropped QRS complex). After the dropped QRS complex, the PR interval resets and the cycle repeats.


One of the baseline assumptions when determining if an individual has Mobitz I heart block is that the sinus rhythm has to be regular. If the sinus rhythm is not regular, there could be alternative explanations as to why the P wave wasn't followed by a QRS complex.


Type 2 Second degree heart block

Type 2 Second degree heart block, also known as Mobitz II heart block is a disease of the distal conduction system. This is also known as Infrahisian block because the level of block is below the bundle of His.


Mobitz II heart block is characterized on a surface ECG by a fixed PR interval with a dropped QRS complex after a certain number of P waves. For instance, for every 4 P waves, there are only 3 QRS complexes. Since there is no lengthening of the PR interval, the PR interval does not reset after the dropped QRS complex.


Related topics


  Results from FactBites:
 
eMedicine - Heart Block, Second Degree : Article by Michael D Levine (1728 words)
The Mobitz II second-degree AV block is characterized by an unexpected nonconducted atrial impulse.
Mobitz type I block is caused by conduction delay in the AV node in 72% of patients and by conduction delay in the His-Purkinje system in the remaining 28%.
Mobitz type I second-degree AV block is localized to the AV node, and thus is not associated with any increased risk of morbidity or death, in the absence of organic heart disease.
eMedicine - Atrioventricular Block, Second Degree : Article Excerpt by: M Silvana Horenstein, MD (682 words)
Mobitz I (Wenckebach) block is often most easily diagnosed by comparing the PR interval after the blocked beat with the PR interval preceding the blocked beat.
When Mobitz I (Wenckebach) block is assessed by means of invasive electrophysiologic study, it is most commonly found to be high in the specialized AV conduction system, usually above the bundle of His in the compact AV node area.
Mobitz I (Wenckebach) AV block may occur normally in the presence of increased vagal tone, such as in athletes or during sleep.
  More results at FactBites »


 

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