Mobitz Type 2 heart block.

Mobitz type 2 heart block.

by Ms Rutledge - 2020-10-20 18:46:44

Thanks.  I saw a new General Practitioner yesterday,and after looking at an Apple Watch EKG, she questioned if it showed 3rd degree heart block.  I thought maybe the Apple Watch was not able to pick up a pacer spike. 

Second degree type-two (Mobitz) heart block

by AgentX86 - 2020-10-20 21:44:24

Unlike Mobitz-1 (Wenckebach), not only can Mobitz-2 (Hay) progress to third degree, it usually does. A pacemaker should be implanted as soon as possibe, before it progresses to third degree.  Mobitz-1 normally doesn't so a pacemakers isn't needed.

Second degree heart block

by Ms Rutledge - 2020-10-20 23:22:40

AgentX86,  I have a Medtronic Pacemaker implanted Aug 2019, I am still having some of the same issues before the pacemaker was implanted, and really having a hard time getting my cardiologist to listen to my complaints.  So I am changing drs. I have taken a few EKGs with an Apple Watch and my new general practitioner looked at them and said I could be having some third degree heart block.  She is referring me to a new cardiologist. I was not aware that with a pacemaker implanted it could still progress from Mobitz type 2 to third degree heart block.  It may not be the case she was not 100 percent sure, it could be the Apple Watch is not capturing everything.   

Apple Watch

by AgentX86 - 2020-10-20 23:36:49

I certainly wouldn't trust your watch and certainly not for something this important.  You should be seeing an electrophysiologist (EP) not a cardiologist for this.  Cardiologists are plumbers.  This is an electrical problem (EPs area).

A pacemaker bypasses the AV node but it can still deteriorate further.  Mobitz-2 and third degree blocks are caused my damage to the heart.  These things normally continue to progress.  Rarely do they stop in the middle.  A pacemaker has little to do with it except, of course, that the block is bypassed so doesn't affect the patient.  Much.

Mobitz-1 is usually caused by some external factor (e.g. illness, drugs,  diet) and when that goes away, so does the arrhythmia.

pacing

by Tracey_E - 2020-10-21 10:26:10

If you progressed from 2nd to 3rd, the pacer would automatically fix it. The only way to know the difference would be to look at the interrogation report and see if you are pacing more. It's possible your settings may need adjusted, but it makes no difference to the pacer how often you are in block. It will pace when you need paced.