ATRIO VENTRICULAR

BLOCKAGE
BY-Swapna
Roll no. 137
 What is Heart Block?
• Heart block is the
disturbance in the normal
transmission of impulse
generated in the SA Node.

• TYPES OF HEART BLOCK:

1. Sino Atrial Block
2. Atrio Ventricular Block
3. Bundle Branch Block
 ATRIO VENTRICULAR BLOCK

 It is a disturbance of conduction between Atria

and the Ventricles.
 There are several conditions that can decrease
or block the impulse entirely:
a) Ischemia of AV Node
b) Compression of AV Bundle
c) Inflammation of AV Node
 Types of AV Block

Incomplete AV Block Complete AV

Block

First Degree Heart Block Second Degree Heart Block

Type 1/ Mobitz 1 Type 2/ Mobitz 2

 Incomplete Atrio Ventricular Block

It is due to partial disturbance of conduction

between atria and ventricles

• FIRST DEGREE HEART BLOCK

 When all atrial impulse reaches to the ventricle,
but PR Interval is abnormally long.
 In normal heart beat, PR Interval is about 0.12 to
0.20 seconds.
 When the PR Interval increases to greater than
0.20 second, the PR Interval is said to be
prolonged and the patient is said to have 1st
degree incomplete heart block.
 So, there is delay of conduction from Atria to
ventricles but not actual blockage of conduction.
• Second degree Heart Block

. When conduction through AV Bundle is slow

enough to increase the PR Interval to 0.25 to 0.45
sec, the action potential is sometime strong enough
to pass through the bundle into the ventricles and
sometimes not strong enough to do so.
. At this instance, there will be atrial P wave but no
QRS wave and there is dropped beats of ventricle.
This condition is called 2nd degree Heart Block.
It is of two types:
a) Type 1/ Wenckebach Periodicity/ Mobitz 1
b) Type 2/ Mobitz 2
 Type 1/ Wenckebach Periodicity/
Mobitz 1
. It is characterized by progressive elongation
of “PR Interval” until the ventricle beat is
dropped and this abnormal cycle repeats.
This is caused by abnormalities of AV Node
 Type 2/ Mobitz 2

. In this case, PR Interval is stable but,

somewhere P wave may not be followed by QRS
complex.
. Ex- 2:1 block implies that there are 2 P wave for
each QRS complex.
. It is generally caused by abnormalities of Bundle
of His and Purnkinje system.
. It may require implantation of Pacemaker to
prevent progression to complete Heart Block and
Cardiac Arrest.
 • Complete Atrio Ventricular Block/
3rd degree Heart Block
 It is due to complete interruption of conduction
between Atria and Ventricles.
 In this case Ventricles spontaneously stablish their
own signal and are independent of the rhythm of
SA Node called IDIO VENTRICULAR Rhythm.
 Therefore, P wave dissociated from QRS-T complex
 Furthermore there is no relation between “P wave”
and “QRS-T complex’ because the ventricle have
escaped from control by the atria and the
ventricles are beating at their own natural rate.
NOTE: The rate of the rhythm of the atria in this ECG
is above 100 beats/min whereas the rate of
ventricular beat is less than 40 beats/min.
 • STOKES ADAMS SYNDROME
• If complete heart block develops suddenly,
there is a delay before ventricles start beating
at its own rate.
• During this period systematic blood pressure
falls to be very low and blood supply to brain
becomes inadequate.
• If Ventriclular standstill last for few seconds it
causes dizziness and faintness called STOKES
ADAMS SYNDROME.
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