Document Detail


2:1 Atrioventricular block: order from chaos.
MedLine Citation:
PMID:  11326349     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
2:1 AV block can occur in either the AV node or the His-Purkinje system and cannot be classified into type I or type II second-degree AV block because there is only one PR interval to examine before the blocked P wave. It is inappropriate to use terms such as 2:1 or 3:1 type I or type II AV block because this characterization violates the accepted traditional definitions of type I and type II block based on electrocardiographic patterns and not on the anatomical site of block. Type I and type II second-degree AV block can progress to 2:1 AV block, and 2:1 AV block can regress to type I or type II block. Consequently, the site of the lesion in 2:1 block can often be determined by seeking the company 2:1 AV block keeps. An association with type I block and a narrow QRS complex almost always reflects AV nodal block but type I block with a wide QRS complex occurs more commonly in the His-Purkinje system than the AV node. Type II block, if correctly defined, is always infranodal. Outside of acute myocardial infarction, sustained 2:1 and 3:1 AV block with a wide QRS complex occurs in the His-Purkinje system in 80% of cases and 20% in the AV node. Administration of atropine in patients with His-Purkinje disease may increase the degree of AV block.
Authors:
S S Barold
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  The American journal of emergency medicine     Volume:  19     ISSN:  0735-6757     ISO Abbreviation:  Am J Emerg Med     Publication Date:  2001 May 
Date Detail:
Created Date:  2001-04-30     Completed Date:  2001-05-24     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8309942     Medline TA:  Am J Emerg Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  214-7     Citation Subset:  IM    
Affiliation:
Electrophysiology Institute, Broward General Hospital, Ft. Lauderdale, FL, USA. ssbarold@aol.com
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MeSH Terms
Descriptor/Qualifier:
Anti-Arrhythmia Agents / contraindications,  therapeutic use
Atrioventricular Node / physiopathology
Atropine / contraindications,  therapeutic use
Electrocardiography*
Emergency Medical Services
Heart Block* / classification,  diagnosis,  drug therapy,  physiopathology
Hemodynamics
Humans
Purkinje Fibers / physiopathology
Chemical
Reg. No./Substance:
0/Anti-Arrhythmia Agents; 51-55-8/Atropine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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