First degree atrioventricular block is a minor delay in the electrical signal between the atria and ventricles, often found incidentally. It is usually asymptomatic and does not require treatment unless it progresses to more severe heart block. Athletes commonly show this pattern in their hearts, and it can also be associated with infectious diseases and heart valve problems. Treatment options range from regular monitoring to artificial pacing.
First degree atrioventricular (AV) block is a variation of the normal heart rhythm in which the electrical signal between the atria and the ventricles is slightly delayed. This condition usually doesn’t cause any symptoms and can be an incidental finding during a routine exam for an unrelated medical problem. Treatment is generally not required unless there is concern that first-degree AV block could progress to more severe heart block, which can be a problem if a patient has an underlying medical problem.
In a patient with first-degree AV block, the PR interval, which is the amount of time it takes for a signal to travel from the atria to the ventricles, is greater than 0.2 seconds. In healthy individuals, this interval is less than 0.2 seconds. The PR interval can be clearly seen on an electrocardiograph, allowing a doctor to diagnose the patient with first degree AV block.
Athletes commonly show this pattern in the electrical signals of their hearts due to increased vagal tone, meaning they are experiencing an increased frequency of impulses from the vagus nerve, causing the heartbeat to become inhibition or strained. People can also develop this condition in association with a variety of infectious diseases and problems with the heart valves. The patient generally has no problems due to the slightly lengthened PR interval. If this condition is identified, the patient may be evaluated for other risk factors to see if future monitoring is needed to check for any changes.
One concern with first-degree AV block is the risk that it may progress to complete AV block, where the signal doesn’t reach the ventricles at all. If a patient has another heart problem or is experiencing a heart attack, there is a risk of the condition escalating in severity. Medications may be provided, and the patient may need a mechanical pacemaker in the future to control the heart rhythm and keep the heart functioning normally.
Many people live with first degree AV block and are unaware of the condition. Others have been diagnosed during a routine doctor visit and may not need to take any further action to address the abnormal heart rhythm. In cases where there is cause for concern, a doctor can discuss how to proceed in the case and provide information about treatment options for the patient. Treatment can range from simply asking a patient for regular electrocardiograms to check for signs of changes to recommending artificial pacing to check the patient’s heartbeat.
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