First-Degree AV Block

Cardiology (Arrhythmia)

Overview

Definition

A delay in conduction from the atria to the ventricles, but all atrial impulses are eventually conducted.

Epidemiology

Common, often a benign incidental finding in young athletes or the elderly.

Etiology & Risk Factors

  • High vagal tone (athletes)
  • Medications (AV nodal blockers)
  • Ischemia
  • Lyme disease

Clinical Symptoms

  • Almost always asymptomatic

Clinical Approach

Diagnosis

  • ECG: Prolonged PR interval (> 200 ms or > 5 small boxes), but every P wave is followed by a QRS complex

Management

  • No treatment required
  • Monitor for progression if on AV nodal blocking drugs

Complications

  • Usually none. Low risk of progressing to higher-degree blocks.