Atrioventricular block pathophysiology: Difference between revisions
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{{CMG}} | {{CMG}}; {{AE}} {{EdzelCo}} | ||
== | ==Overview== | ||
Atrioventricular (AV) block is caused by one of the following mechanisms i.e. [[fibrosis]] or degeneration of the conduction system, [[ischemic heart disease]], or medications. | [[Atrioventricular]] (AV) block is caused by one of the following mechanisms i.e. [[fibrosis]] or degeneration of the [[conduction system]], [[ischemic heart disease]], or [[medications]]. | ||
==Atrioventricular Block Pathophysiology== | |||
*[[First-degree atrioventricular block]] | |||
**A delay in electrical [[heart conduction]] without significant interruption occurs from [[atria]] to [[ventricle]]. | |||
**This occurs at the level of [[atrioventricular node]] ([[AV node]]) or slightly below it. | |||
**In this situation, no [[hemodynamic instability]] happens. | |||
*[[Second-degree atrioventricular block Mobitz type 1]] ([[Wenckebach]]) | |||
**A block in the normal [[electrical conduction system]] occurs at the crest of [[AV node]]]as a result of failure of [[AV nodal cells]] to transmit the [[cardiac impulse]] to the [[ventricles]]. | |||
**This is related to a progressive fatigue of the [[cells]] and result is manifested as a [[dropped beat]]. | |||
*[[Second-degree atrioventricular block Mobitz type 2]] | |||
**The [[electrical conduction system]] blockage occurs at the level below the [[AV node]] ([[His bundle]], [[bundle branches]], and [[heart fascicles]]. | |||
*[[Third-degree atrioventricular block]] | |||
**There are two possible locations in this block with [[impulse conduction]] depending on the location of the block. | |||
**A narrow [[QRS complex]] with [[AV node intrinsic rate]] of 40 to 55 beats per minute is observed when the block is at the crest of [[AV node]] or above it. | |||
**A wide [[QRS complex]] with a [[ventricular pacemaker intrinsic rate]] of 20 to 40 beats per minute is observed when the block is below the [[AV node]].<ref name="pmid29083636">{{cite journal| author=| title=StatPearls | journal= | year= 2022 | volume= | issue= | pages= | pmid=29083636 | doi= | pmc= | url= }} </ref> | |||
==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
{{WH}} | |||
{{WS}} | |||
[[CME Category::Cardiology]] | |||
[[Category:Cardiology]] | [[Category:Cardiology]] | ||
[[Category:Electrophysiology]] | [[Category:Electrophysiology]] | ||
[[Category:Disease]] | [[Category:Disease]] | ||
[[Category:Needs content]] | [[Category:Needs content]] | ||
Latest revision as of 05:43, 28 November 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Edzel Lorraine Co, DMD, MD[2]
Overview
Atrioventricular (AV) block is caused by one of the following mechanisms i.e. fibrosis or degeneration of the conduction system, ischemic heart disease, or medications.
Atrioventricular Block Pathophysiology
- First-degree atrioventricular block
- A delay in electrical heart conduction without significant interruption occurs from atria to ventricle.
- This occurs at the level of atrioventricular node (AV node) or slightly below it.
- In this situation, no hemodynamic instability happens.
- Second-degree atrioventricular block Mobitz type 1 (Wenckebach)
- A block in the normal electrical conduction system occurs at the crest of AV node]as a result of failure of AV nodal cells to transmit the cardiac impulse to the ventricles.
- This is related to a progressive fatigue of the cells and result is manifested as a dropped beat.
- Second-degree atrioventricular block Mobitz type 2
- The electrical conduction system blockage occurs at the level below the AV node (His bundle, bundle branches, and heart fascicles.
- Third-degree atrioventricular block
- There are two possible locations in this block with impulse conduction depending on the location of the block.
- A narrow QRS complex with AV node intrinsic rate of 40 to 55 beats per minute is observed when the block is at the crest of AV node or above it.
- A wide QRS complex with a ventricular pacemaker intrinsic rate of 20 to 40 beats per minute is observed when the block is below the AV node.[1]