First degree AV block pathophysiology: Difference between revisions
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==Overview== | ==Overview== | ||
The atrioventricular node is a normal electrical pathway between the atria and ventricles and it is located in the right atrium. First degree AV block pathogenesis can be attributed to an electrical conduction delay in the AV node or His-Purkinje system. First degree AV block can be associated with normal QRS complex or wide QRS complex on the ECG. | The [[atrioventricular node ]] is a normal [[electrical]] pathway between the [[atria]] and [[ventricles]] and it is located in the [[right atrium]]. [[First-degree AV block]] pathogenesis can be attributed to an [[electrical]] conduction delay in the [[AV node]] or [[His-Purkinje system]]. [[First-degree AV block]] can be associated with normal [[QRS complex]] or wide [[QRS]] complex on the [[ECG]]. | ||
==Pathophysiology== | ==Pathophysiology== | ||
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=== Physiology === | === Physiology === | ||
* The atrioventricluar node is the normal electrical pathway between the atria and ventricles. It is located in the right atrium near to the tricuspid valve leaflet. | * The [[atrioventricluar node]] is the normal [[electrical pathway]] between the [[atria]] and [[ventricles]]. It is located in the [[right atrium]] near to the [[tricuspid valve]] leaflet. | ||
* The AV node receives blood supply from the right coronary artery in most of the population. | * The [[AV node]] receives [[blood]] supply from the [[right coronary artery]] in most of the population. | ||
* The bundle of His is the electrical connection | * The [[ bundle of His]] is the [[electrical]] connection between the [[AV node]] to the [[interventricular septum]]. At the end of the [[septum]], a [[bundle of His]] is divided into the right and [[left bundle branches]] to the [[ventricular]] walls. | ||
===Pathogenesis=== | ===Pathogenesis=== | ||
* First degree AV block broadly means the prolongation of the PR interval on the ECG with normal atrioventricular node function. | * [[First-degree AV block]] broadly means the prolongation of the [[PR interval]] on the [[ECG ]] with normal [[atrioventricular node]] function. | ||
* First degree AV block pathogenesis can be attributed to an electrical conduction delay in one of the following:<ref name="pmid30105427">{{cite journal| author=Lewalter T, Pürerfellner H, Ungar A, Rieger G, Mangoni L, Duru F et al.| title="First-degree AV block-a benign entity?" Insertable cardiac monitor in patients with 1st-degree AV block reveals presence or progression to higher grade block or bradycardia requiring pacemaker implant. | journal=J Interv Card Electrophysiol | year= 2018 | volume= 52 | issue= 3 | pages= 303-306 | pmid=30105427 | doi=10.1007/s10840-018-0439-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30105427 }} </ref> | * [[First-degree AV block]] pathogenesis can be attributed to an electrical conduction delay in one of the following:<ref name="pmid30105427">{{cite journal| author=Lewalter T, Pürerfellner H, Ungar A, Rieger G, Mangoni L, Duru F et al.| title="First-degree AV block-a benign entity?" Insertable cardiac monitor in patients with 1st-degree AV block reveals presence or progression to higher grade block or bradycardia requiring pacemaker implant. | journal=J Interv Card Electrophysiol | year= 2018 | volume= 52 | issue= 3 | pages= 303-306 | pmid=30105427 | doi=10.1007/s10840-018-0439-7 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30105427 }} </ref> | ||
** Atrioventricular node | ** [[Atrioventricular node]] | ||
** His-Purkinje system which is formed of both bundle of His and Purkinje fibers | ** [[His-Purkinje system]] which is formed of both [[bundle of His]] and [[Purkinje fibers]] | ||
* The conduction delay can be also in both | * The conduction delay can be also in both the [[AV node]] and [[His-Purkinje system]]. | ||
* One of the characteristics of first degree AV block that there are no beats skipped and it has a regular rhythm. | * One of the characteristics of [[first-degree AV block]] is that there are no [[beats]] skipped and it has a regular [[rhythm]]. | ||
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<gallery heights="175" widths="175"> | <gallery heights="175" widths="175"> | ||
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===First | ===[[First-degree AV Block]] with Normal [[QRS]] Duration=== | ||
First degree AV block with normal QRS duration | [[First-degree AV block]] with normal [[QRS]] duration results from [[atrial]] or [[AV nodal]] delay. | ||
===First | ===[[First-degree AV Block]] with Wide [[QRS]] Complex=== | ||
First degree AV block with [[wide QRS complex]] most often results from delay in conduction in the bundle of His and in some patients, the [[AV node]]. | [[First-degree AV block]] with [[wide QRS complex]] most often results from delay in conduction in the [[bundle of His]] and in some [[patients]], the [[AV node]]. | ||
==References== | ==References== | ||
Latest revision as of 04:39, 22 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Mohammed Salih, M.D., Ahmed Elsaiey, MBBCH [2], Cafer Zorkun, M.D., Ph.D. [3]
Overview
The atrioventricular node is a normal electrical pathway between the atria and ventricles and it is located in the right atrium. First-degree AV block pathogenesis can be attributed to an electrical conduction delay in the AV node or His-Purkinje system. First-degree AV block can be associated with normal QRS complex or wide QRS complex on the ECG.
Pathophysiology
Physiology
- The atrioventricluar node is the normal electrical pathway between the atria and ventricles. It is located in the right atrium near to the tricuspid valve leaflet.
- The AV node receives blood supply from the right coronary artery in most of the population.
- The bundle of His is the electrical connection between the AV node to the interventricular septum. At the end of the septum, a bundle of His is divided into the right and left bundle branches to the ventricular walls.
Pathogenesis
- First-degree AV block broadly means the prolongation of the PR interval on the ECG with normal atrioventricular node function.
- First-degree AV block pathogenesis can be attributed to an electrical conduction delay in one of the following:[1]
- Atrioventricular node
- His-Purkinje system which is formed of both bundle of His and Purkinje fibers
- The conduction delay can be also in both the AV node and His-Purkinje system.
- One of the characteristics of first-degree AV block is that there are no beats skipped and it has a regular rhythm.
First-degree AV Block with Normal QRS Duration
First-degree AV block with normal QRS duration results from atrial or AV nodal delay.
First-degree AV Block with Wide QRS Complex
First-degree AV block with wide QRS complex most often results from delay in conduction in the bundle of His and in some patients, the AV node.
References
- ↑ Lewalter T, Pürerfellner H, Ungar A, Rieger G, Mangoni L, Duru F; et al. (2018). ""First-degree AV block-a benign entity?" Insertable cardiac monitor in patients with 1st-degree AV block reveals presence or progression to higher grade block or bradycardia requiring pacemaker implant". J Interv Card Electrophysiol. 52 (3): 303–306. doi:10.1007/s10840-018-0439-7. PMID 30105427.