Tuesday, October 20, 2009

Heart Block

1st Degree:
- PR interval prolonged > 200msec
- QRS follows every P wave
- Delay usually in the AV node
- Benign, does not require treatment

2nd Degree Mobitz I:
- Progressive prolongation of PR interval until a P wave fails to conduct
- Block usually in the AV node
- Benign, does not require treatment

2nd Degree Mobitz II:
- P wave randomly fails to conduct, resulting in sudden drops of QRS complexes (no preceding PR interval prolongation)
- Block is in the His-Purkinje system
- Often progresses to 3rd degree heart block, requires pacemaker implantation

3rd Degree:
- AV dissociation: absence of conduction of atrial impulses to ventricles (P waves do not correspond to QRS complexes)
- Separate atrial rate and ventricular rate (ventricular escape rhythm ~25-40bpm)
- Requires pacemaker implantation

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