Tags

Type your tag names separated by a space and hit enter

First-degree AV block associated with increased risk of adverse outcomes

General

Clinical Question:
Is first-degree atrioventricular block associated with an increased risk for adverse cardiovascular events?

Bottom Line:
First-degree atrioventricular (AV) block, defined as a PR interval exceeding 200 milliseconds, is associated with a significantly increased risk of atrial fibrillation, pacemaker insertion, and all-cause mortality. (LOE = 1b)

Reference:
Cheng S, Keyes MJ, Larson MG, et al. Long-term outcomes in individuals with prolonged PR interval or first-degree atrioventricular block. JAMA 2009;301(24):2571-2577.  [PMID:19549974]

Study Design:
Cohort (prospective)

Setting:
Population-based

Synopsis:
Although commonly seen in clinical practice, the significance of first-degree AV block (PR interval exceeding 200 milliseconds) is unknown. These investigators analyzed data from the well-known Framingham Heart Study, a community-based cohort identified in 1968-1974, including 7575 individuals (mean age = 47 years; 54% women) prospectively followed through 2007. Three individuals reviewed medical histories, physical examinations from hospitalizations, and personal physician records for all patients with suspected new events. A cardiologist evaluated all electrocardiograms. At baseline, first-degree AV block occurred in 124 participants. Compared with individuals having a normal PR interval, adverse outcomes including atrial fibrillation (number needed to treat to harm [NNTH] = 96), pacemaker implantation (NNTH = 189), and all-cause mortality (NNTH = 49) occurred significantly more often in those having baseline first-degree AV block. An additional 161 individuals with an initially normal PR interval at baseline who developed first-degree AV block during follow-up also had a significantly increased occurrence of atrial fibrillation and pacemaker insertion, but not all-cause mortality.

First-degree AV block associated with increased risk of adverse outcomes is a sample topic from the EE+ POEM Archive.

To view other topics, please or purchase a subscription.

Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. Learn more.

Citation

Slawson, David C., et al., editors. "First-degree AV Block Associated With Increased Risk of Adverse Outcomes." EE+ POEM Archive, John Wiley & Sons, 2019. Evidence Central, evidence.unboundmedicine.com/evidence/view/infoPOEMs/426876/all/First_degree_AV_block_associated_with_increased_risk_of_adverse_outcomes.
First-degree AV block associated with increased risk of adverse outcomes. In: Slawson DC, Shaughnessy AF, Ebell MH, et al, eds. EE+ POEM Archive. John Wiley & Sons; 2019. https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426876/all/First_degree_AV_block_associated_with_increased_risk_of_adverse_outcomes. Accessed May 27, 2019.
First-degree AV block associated with increased risk of adverse outcomes. (2019). In Slawson, D. C., Shaughnessy, A. F., Ebell, M. H., & Barry, H. (Eds.), EE+ POEM Archive. Available from https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426876/all/First_degree_AV_block_associated_with_increased_risk_of_adverse_outcomes
First-degree AV Block Associated With Increased Risk of Adverse Outcomes [Internet]. In: Slawson DC, Shaughnessy AF, Ebell MH, Barry H, editors. EE+ POEM Archive. John Wiley & Sons; 2019. [cited 2019 May 27]. Available from: https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426876/all/First_degree_AV_block_associated_with_increased_risk_of_adverse_outcomes.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - First-degree AV block associated with increased risk of adverse outcomes ID - 426876 ED - Slawson,David C, ED - Shaughnessy,Allen F, ED - Ebell,Mark H, ED - Barry,Henry, BT - EE+ POEM Archive UR - https://evidence.unboundmedicine.com/evidence/view/infoPOEMs/426876/all/First_degree_AV_block_associated_with_increased_risk_of_adverse_outcomes PB - John Wiley & Sons DB - Evidence Central DP - Unbound Medicine ER -