B

Fig. 20. Mobitz 1 2nd degree A-V block (A), 2:1 A-V block (B), and third-degree A-V block (C) in this patient with acute IMI. The ventricular escape rate in this case is relatively low for heart block related to IMI, but the QRS complex is narrow. Atropine improved A-V conduction.

Mobitz II Second-Degree and Third-Degree AV Block

High-grade AV block is a more ominous sign in the setting of AMI. Mobitz II heart block occurs in less than 1% of patients with AMI (124). Complete heart block (CHB, see Fig. 20, 21) complicated 11% of IMIs managed conservatively in the SPRINT study (125) and 13% of IMIs managed with thrombolytic therapy in the TAMI database

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