Monday, February 16, 2015

Study group discussion: AV blocks simplified

Tell me little bit about what do you know about AV Block?

They occur when atrial depolarizations fail to reach the ventricles or when atrial depolarization is conducted with a delay. There are 3 degrees which we can recognize.

First degree consists of prolongation of the PR interval on the ECG (>200 msec in adults and >160 msec in young children).

In second degree, we can find atrial impulses that fail to conduct to the ventricles. And variations like mobitz I and II.

And finally, third degree, where we get multiple P waves that don't conduct at all.

Tell me differences in type 1 and 2 mobitz?

Well, in type I there is a prolongation of the PR interval until it drops and doesnt conduct

And in type 2, there is a constant PR interval and then it drops (:

If your R is far from P, then you have a 1st degree.
Longer, longer, longer, drop...Then you have a Wenckebach.
If your PS don't go through, then you have a Mobitz 2.
If your PS don't agree, then you have a 3rd degree.

What's the treatment? For all of them?

First and second degree (mobitz I) only require treatment if they are symptomatic.

Mobitz II and 3rd degree usually require temporary and/or permanent cardiac pacing.

This was fun, thanks for the drawings!

*the drawings of medcomic were shared on the group, you should check them out*

Review question:
Which of the following is not a feature of complete heart block on the ECG:
a) Constant RR interval
b) Constant PP interval
c) Constant PR interval
d) PP interval shorter than RR interval

Answer: C

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