Impulse propagation from the atrioventricular node through the His-Purkinje system, bundle branches, and fascicles is blocked. The site of block should be determined as this can indicate the likelihood of a stable escape rhythm and the risk of progression to complete heart block ( Table 1). Patients with atrioventricular conduction abnormalities may have abnormalities in autonomic tone, particularly heightened vagal stimulation. Atrioventricular conduction block may be due to myocardial ischemia, chronic hypertension, digoxin toxicity, b-blockers, calcium-channel blockers, myocarditis, acute rheumatic fever, myocardial calcification, aortic stenosis, mitral stenosis, and congenital atrioventricular block.
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