Heart Blocks

Conduction

Recognition

  • • 1°: PR >200 ms
  • • 2° Mobitz I: progressive PR prolongation → dropped beat
  • • 2° Mobitz II: fixed PR with dropped beats
  • • 3°: AV dissociation

Key findings

  • • Narrow vs wide escape
  • • Site: AV node (Wenckebach) vs infranodal (Mobitz II / 3°)

Clinical importance

  • • Mobitz II and complete heart block need pacing

Management pearls

  • • Atropine 0.5 mg IV (nodal disease)
  • • Transcutaneous pacing
  • • Adrenaline/dopamine infusion
  • • Transvenous → permanent pacemaker
WardRound

WardRound

Clinical Decisions in Seconds