Editorial
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Cardiol. Jul 26, 2024; 16(7): 385-388
Published online Jul 26, 2024. doi: 10.4330/wjc.v16.i7.385
Misinterpretation of sleep-induced second-degree atrioventricular block
S Serge Barold
S Serge Barold, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642, United States
Author contributions: Barold SS wrote and revised this editorial.
Conflict-of-interest statement: Dr. Barold has nothing to disclose.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: S Serge Barold, MD, Professor, Department of Medicine, University of Rochester School of Medicine and Dentistry, 601 Elmwood Av, Rochester, NY 14642, United States. ssbarold@aol.com
Received: June 18, 2024
Revised: June 26, 2024
Accepted: July 9, 2024
Published online: July 26, 2024
Processing time: 36 Days and 12.2 Hours
Abstract

A number of publications have claimed that Mobitz type II atrioventricular block (AVB) may occur during sleep. None of the reports defined type II AVB and representative electrocardiograms were either misinterpreted or missing. Relatively benign Wenckebach type I AVB is often misdiagnosed as Mobitz type II which is an indication for a pacemaker. Review of the published reports indicates that Mobitz type II AVB does not occur during sleep when it is absent in the awake state. Conclusion: There is no proof that sleep is associated with Mobitz type II AVB.

Keywords: Wenckebach type I atrioventricular block; Mobitz type II atrioventricular block; Vagal tone; Heart block; Cardiac pacemaker

Core Tip: A number of publications have claimed that Mobitz type II atrioventricular block (AVB) may occur during sleep. None of the reports defined it and representative electrocardiograms were either misinterpreted or missing. Sleep-induced relatively benign narrow QRS-Mobitz type I AVB must be differentiated from serious Mobitz type II AVB. This depends solely on strict electrocardiograms definitions and behavior of the sinus rate where slowing rules out Mobitz type II AVB even if all the PR intervals are constant. Mobitz type II AVB does not occur solely during sleep when it is absent in the awake state.