Mobitz Type II AV Block???

Hi Dr,

I posted here about my mitral valve prolapse and left ventricle hyperthrophy. I went to my md last week and he requested for 24hr holter now my concern is the result.

during the 24 hour monitoring i also did my daily 30mins run/walk @gym

heres the interpretation

1. Basic rhytm is sinus with frequent episodes of mobitz type II AV Block , Heart rate range from 29 - 183 BPM with an average of 72BPM

2. Low frequency premature ventricular complexes occuring singly and occasionally bigeminy

3. No premature atrial complexes

4. No significant st segment shifts

5. No reported symptoms

to i have to worry about?

Thanks!

[CCFCardio MD2]

I'm sorry to hear about your troubles.  If you truly had Mobitz type II on your Holter monitor, you need to talk to your cardiologist about further workup.  While Mobitz II can be due to something that is relatively benign, such as increased vagal tone, it can also be very concerning.  Mobitz II is a type of heart block where your heart does not conduct its signal through the AV node of the heart as it should.  This leads to a transient heart block.  It usually resets and there is no major consequence, but if the pause is long enough it can lead to symptoms such as loss of consciousness.  The major concern with Mobitz Type II is that it can deteriorate into complete (3rd degree) heart block.  This is life threatening.  Many patients with Mobitz type II are treated with a permanent pacemaker.  Please discuss with your cardiologist about whether you warrant this type of treatment.  Best of luck to you.

[mbclubph]

Dr. please give me some explanation im kinda worried now.... thanks

[is_something_wrong]

Hi,

I'm sure the doctor will answer soon. It takes from 1 to 5 days, probably because they have patients in real life too :)

In the meantime, I can try to explain some of this.

The only "abnormal" finding here is the AV block. PVCs are normal to a certain degree, the max heart rate is fine, there were no PACs (even if it were, it's normal, by the way) and no signs of ischemia (lack of oxygen to the heart muscle).

The AV block should be interpreted by your cardiologist. You can have AV block in several degrees, where the 1st degree is asymptomatic and just indicates prolonged conduction time between upper and lower chambers. A common finding in well-trained young men and women, and it often appears during rest. The second degree (Mobitz) AV block is divided in two disorders, the type I (Wenchebach) that is gradually prolonged conduction, until a beat is missed (feels like a PVC), the process is reset and repeated. It's common in well trained individuals, especially at night.

The type II (Hay, I really don't know where all those names come from) is a sudden block of a beat. It can be found in healthy people, but it should be evaluated. A good thing here is that you didn't have any symptoms. My guess is that your exercise condition is good!

What did your cardiologist say about this? In my country, general physicians don't perform Holter tests, only cardiologists do, and they provide the results, with explaination, when you have the consultation. We never get to see the results (in numbers) if we don't ask for it (I always do, because it's really interesting.)

Are you sure it's II degree Mobitz type II and not II degree Mobitz type I? It's a lot of numbers, and easy to misread/misunderstand. When did the AV block appear? During rest or during activity?

Again, if you are feeling well, it's a good sign. I would recommend you to contact your cardiologist or the doctor that performed the test, and ask for his comments. My experience is that it's a bad idea to contact another doctor, they can only give general comments, and this is of limited value to you.

Best wishes to you :) I really hope the doctor will answer you soon, because this fear and anxiety about your heart is really unpleasant, I know, I've been there.

[mbclubph]

5 days still counting  doctor please reply..... thanks

[mbclubph]

please help...

[is_something_wrong]

See answer from cardiologist above :)

[mbclubph]

thanks for the answer doctor and  is_something_wrong , my cardiologist already check the tracing of my holter and he said i have to go back in 2 weeks and he told me im ok. is there such thing as ok if you have a mobitz type II av block?