Overview
First-degree atrioventricular (AV) block is characterized by a prolonged PR interval on the surface electrocardiogram (ECG) without complete AV block. It is relatively common in asymptomatic young individuals with reported prevalences ranging from 0.65% to 1.1% 2.Diagnosis
Key Diagnostic Criteria: Prolonged PR interval on ECG 2.
Recommended Tests: Exclusion of organic heart disease through clinical evaluation and possibly additional ECG monitoring 2.
Grading: Not typically graded; diagnosis based on ECG findings 2.Management
First-Line Management: No specific treatment required; management focuses on monitoring and exclusion of underlying causes 2.
Adjunctive Treatments: Not typically indicated unless associated with other conditions requiring intervention 2.Special Populations
Pregnancy: No specific guidance provided in the abstracts 1.
Pediatrics: No specific guidance provided in the abstracts 1.
Elderly: No specific guidance provided in the abstracts 1.
Comorbidities: Focus on excluding organic heart disease in all populations 2.Key Recommendations
First-degree AV block is generally benign and does not warrant restriction on fitness to fly 2 (Evidence: Strong).
Detailed invasive investigations are not typically necessary unless organic heart disease is suspected 2 (Evidence: Strong).
Increased electrocardiographic scrutiny may be considered for individuals diagnosed with first-degree AV block 2 (Evidence: Moderate).References
1 Michau A, Gitz L, Proulx F, Besse M, Tezenas du Montcel S, Leclère B et al.. Pulsed Doppler fetal atrioventricular interval measurement: Assessment of a new image scoring method. Journal of gynecology obstetrics and human reproduction 2019. link
2 Bexton RS, Camm AJ. First degree atrioventricular block. European heart journal 1984. link