First degree AV block pathophysiology: Difference between revisions
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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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===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. Other probable sites include the [[bundle of His]] and [[infra-Hisian]] conduction system. | ||
===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== | ||
Revision as of 10:42, 18 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. Other probable sites include the bundle of His and infra-Hisian conduction system.
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.