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===2. AV Block===  
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== Introduction ==
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*The delay or failure of the atrioventricular node to conduct impulses.
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Atrio-ventricular block is the delay or failure of the atrioventricular node to conduct impulses.  
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There are three types of AV block:
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====1st Degree (Partial AV Block)====
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'''1st Degree''' (Partial AV Block) - Delayed conduction through the AV node. Causes include electrolyte imbalance, drug reactions and degenerative changes in the AV node. It may be a permanent or temporary condition.
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*Delayed conduction through the AV node
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'''2nd Degree''' (Partial AV Block) - Intermittent failure of conduction through the AV node.
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:Mobitz Type I. = prolonged P-R interval
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:Mobitz Type II. = no prolongation of the P-R interval.
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:There are also sub types with Type A: normal QRS length; block is above the bundle of His division (Most commonly seen with Mobitz Type I.)
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:Type B: longer QRS length; block is below the bundle of His division (Most commonly seen with Mobitz Type II.).
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'''Causes'''
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:Causes include electrolyte imbalance, drug reactions and degenerative changes in the AV node. The condition may be temporary or permanent.
Electrolyte imbalance, drug reactions, degenerative changes in the AV node  
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'''3rd Degree''' (Total AV Block) - Total failure of AV conduction causing uncoordinated and independent atrial and ventricular depolarisations. Causes include electrolyte disturbances, drug toxicities (e.g. digitalis), acquired nodal diseases, [[:Category:Cardiomyopathy|cardiomyopathies]], [[hypothyroidism]], [[endocarditis]], [[Lyme Disease]] etc. This is a permanent life threatening condition.
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'''ECG Appearance:''' Longer P-R interval
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== Clinical Signs ==
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'''Treatment''' Treat the underlying cause
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Depending on which type of block and severity, clinical signs may vary. Signs may include weakness, syncope, exercise intolerance and pallor.
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====2nd Degree (Partial AV Block)====
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*Intermittent failure of conduction through the AV node
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== Diagnosis ==
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Clinical signs plus auscultation of the heart will be indicative of the condition.
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'''Mobitz Type I.'''= prolonged P-R interval
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An '''ECG''' will show characteristic results which will confirm the diagnosis. In 1st degree AV block there will be a longer P-R interval on ECG. In 2nd degree AV block some P waves are not followed by QRS complexes. In 3rd degree AV block there will be independent regular and fast P waves or independent regular and slow QRS waves.
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'''Mobitz Type II.'''= no prolongation of the P-R interval
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== Treatment and Control ==
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1st degree AV block - treat the underlying cause.
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'''Type A:''' normal QRS length; block is above the bundle of His division (Most commonly seen with Mobitz Type I.)
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2nd degree Av block - Mobitz Type I.: Treat underlying cause if necessary. Mobitz Type II. Treat with atropine etc. or surgical implantation of a pacemaker.  
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3rd degree AV block needs surgical intervention and the implantation of a cardiac pacemaker.
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'''Type B:''' longer QRS length; block is below the bundle of His division (Most commonly seen with Mobitz Type II.)
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== References ==
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'''Causes''' Electrolyte imbalance, drug reactions, degenerative changes in the AV node
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Ettinger, S.J. and Feldman, E. C. (2000) Textbook of Veterinary Internal Medicine Diseases of the Dog and Cat Volume 2 (Fifth Edition) W.B. Saunders Company
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Ettinger, S.J, Feldman, E.C. (2005) Textbook of Veterinary Internal Medicine (6th edition, volume 2)W.B. Saunders Company
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'''ECG Appearance:''' Some P waves are not followed by QRS complexes
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Fossum, T. W. et. al. (2007) Small Animal Surgery (Third Edition) Mosby Elsevier
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'''Treatment'''
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{{review}}
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Mobitz Type I.: Treat underlying cause if necessary
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{{OpenPages}}
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Mobitz Type II. Treat with atropine etc. or surgical implantation of a pacemaker
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[[Category:Impulse_Conduction_Abnormalities]] [[Category:Expert_Review]]
 
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[[Category:Cardiology Section]]
====3rd Degree (Total AV Block)====
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*Total failure of AV conduction causing uncoordinated and independent atrial and ventricular depolarisations
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'''Causes''' Electrolyte disturbances, drug toxicities (e.g. digitalis), acquired nodal diseases, cardiomyopathies, hypothyroidism, endocarditis, [[Lyme disease]] etc.
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'''ECG Appearance:''' Independent regular and fast P waves; independent regular and slow QRS waves
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'''Treatment''' Treat underlying disease, atropine etc., implantation of a cardiac pacemaker[[Category:Impulse_Conduction_Abnormalities]][[Category:To_Do_-_Cardiovascular]]
 
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