First degree AV block history and symptoms

Symptoms related to atrioventricular block vary and related to the degree of atrioventricular block, the ventricular rate, and the frequency of its occurrence. Patients presented with First-degree AV block are usually asymptomatic. However, severe first-degree AV block may cause symptoms similar to pace maker syndrome including heart failure symptoms, exertional intolerance. Pseudo pacemaker syndrome is defined when the PR interval is >300ms leading to atrial contraction during the closed atrioventricular valves, loss of atrioventricular synchrony and decrease in cardiac output and an increase pulmonary capillary wedge pressure.

• In patients presented with symptoms suspicious for bradycardia or conduction disorder, comprehensive history should be taken about:^[1]

• Timing, duration, severity, longevity, circumstances, triggers and alleviating factors of symptoms
• The relationship of the symptoms to medications, meals, medical interventions, emotional distress, physical exertion, positional changes, and triggers (eg, urination, defecation, cough, prolonged standing, shaving)
• systemic illness or heart disease
• cardiovascular risk assessment, family history, travel history, and review of systems

• Symptoms related to atrioventricular block vary and related to the degree of atrioventricular block, the ventricular rate, and the frequency of its occurrence.

• Patients presented with First-degree AV block are usually asymptomatic. However, severe First-degree AV block may cause symptoms similar to pace maker syndrome including heart failure symptoms, exertional intolerance.
• Common symptoms associate with profound First-degree atrioventricular block with PR interval >300 ms include:
• Fatigue
• Exertional intolerance
• Malaise
• Lightheadedness
• Chest pain
• Syncope
• Pseudo pacemaker syndrome is defined when the PR interval is >300ms leading to atrial contraction during the closed atrioventricular valves, loss of atrioventricular synchrony and decrease in cardiac output and an increase pulmonary capillary wedge pressure.^[2]

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