First degree AV block natural history, complications and prognosis: Difference between revisions
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==Complications== | ==Complications== | ||
Common complications of [[first-degree heart block]] may include the following: | |||
* | * Increased risk of [[atrial fibrillation]] | ||
* Increased risk of [[Pacemaker implantation]] | |||
* [[Pacemaker | |||
Individuals who have first degree block as part of a triad of first degree heart block, [[right bundle branch block]], and either [[left anterior fascicular block]] or [[left posterior fascicular block]] (known as [[trifascicular block]]) may be at an increased risk of progression to [[complete heart block]]. | |||
Individuals who have first-degree block as part of a triad of first-degree heart block, [[right bundle branch block]], and either [[left anterior fascicular block]] or [[left posterior fascicular block]] (known as [[trifascicular block]]) may be at an increased risk of progression to [[complete heart block]]. | |||
==Prognosis== | ==Prognosis== | ||
Revision as of 04:03, 17 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
Natural History
Isolated first degree heart block has few if any clinical consequences. There are no symptoms or signs associated with it, and there is little danger of progression to complete heart block.
- In the setting of neuromuscular diseases such as myotonic dystrophy 1 with conduction abnormalities in the heart, First-degree AV block may progress to complete heart bloc during variable period of time.
Complications
Common complications of first-degree heart block may include the following:
- Increased risk of atrial fibrillation
- Increased risk of Pacemaker implantation
Individuals who have first-degree block as part of a triad of first-degree heart block, right bundle branch block, and either left anterior fascicular block or left posterior fascicular block (known as trifascicular block) may be at an increased risk of progression to complete heart block.
Prognosis
- Prognosis of first degree AV block is controversial. Some studies showed the first degree AV block associated with good prognosis and others showed worse prognosis with advanced PR prolongation.[1]
- Presence of first degree AV block in healthy people and in patients with coronary heart disease is shown to be associated with higher risk of morbidity and mortality.[2]
- In a 2016 meta-analysis, first degree AV block was found to be associated with higher mortality risk. It was also associated with a high risk of heart failure, left ventricular dysfunction, and atrial fibrillation. However, it was not associated with high risk of coronary artery disease, stroke, or myocardial infarction.[3]
References
- ↑ Cheng S, Keyes MJ, Larson MG, McCabe EL, Newton-Cheh C, Levy D, Benjamin EJ, Vasan RS, Wang TJ (2009). "Long-term outcomes in individuals with prolonged PR interval or first-degree atrioventricular block". JAMA. 301 (24): 25712577. doi:10.1001/jama.2009.888.
- ↑ Erikssen J, Otterstad JE (1984). "Natural course of a prolonged PR interval and the relation between PR and incidence of coronary heart disease. A 7-year follow-up study of 1832 apparently healthy men aged 40-59 years". Clin Cardiol. 7 (1): 6–13. doi:10.1002/clc.4960070104. PMID 6705291.
- ↑ Kwok CS, Rashid M, Beynon R, Barker D, Patwala A, Morley-Davies A; et al. (2016). "Prolonged PR interval, first-degree heart block and adverse cardiovascular outcomes: a systematic review and meta-analysis". Heart. 102 (9): 672–80. doi:10.1136/heartjnl-2015-308956. PMID 26879241.