Overview of acute management of Mobitz type II second-degree AV block

AV: atrioventricular.

* Hemodynamic instability is identified by signs and symptoms of inadequate tissue perfusion, which include hypotension, lightheadedness, altered mental status, poor peripheral perfusion, and other signs of shock.

¶ Temporary cardiac pacing is performed with transcutaneous or transvenous pacing. Transcutaneous pacing may be initiated while access for transvenous pacing is obtained.

Δ Beta adrenergic agents which may be used in this setting include isoproterenol, dopamine, dobutamine, and epinephrine. Refer to UpToDate content regarding use of these chronotropic agents. Atropine is generally avoided in patients with Mobitz type II second-degree block as it is unlikely to be beneficial and may worsen infranodal block by increasing sinus rate without improving conduction.