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Second Degree, Type I


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I didnt have my event monitor on tonight like a good little girl that I SHOULD be to try and catch this flutter sensaton ....I didnt get a flutter sensation, but I started to feel woozy, so I went in the back room, hooked myself up to a continuous ECG monitor and saw the well known and beloved sinus tachy around 170 standing (I'm still on beta too)...I felt really light headed and felt like hitting the floor, so I laid down and continued to let the monitor record and I went into Second degree Type I....I know this isnt very dangerous in most situations, in that type II is more concerning, but I wonder when you have symptoms as I did, what to do? I think maybe I should give the rhythm strip to the doc?

flop, you out there? I know you mentioned you went into mobitz I ...did you have symptoms with it?

hmmmm......

glad I caught it, but dont think there's much they'll do about it. I WANT to catch this OTHER thing, the flutter thing....ironically enough, the woozy sensation I got tonight is the same sensation I get before the flutter happens, but it didnt happen tonight....??

strange....

-cardiactec....

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Hi Angela,

yep I'm arround at the moment :(

Seen as you have caught the Mobitz type I on paper I would give it to your cardiologist next time you see him/her.

Don't forget that Mobitz type I is relatively common amoungst youngsters like us.

This is just me thinking, so go with what your doc says but: if you were feeling woozy and the first rhythm you saw was sinus tachy, then you went into the 2 degree block then it is probably the tachy or associated BP change that made you feel woozy rather than the AV block. It is possible that the tachy was causing the AV node to get fatigued and therefore increase it's refractory time and give you the typical Mobitz type I pattern?

The times that I have been in Mobitz I have been picked up incidentally on Holter moniters, I have never reported any symptoms at those specific times. I tend to brady out at night down to 32-36/min and when I speed back up again seeps to be when the Mobitz I occurs. I have noticed times when my pulse has been irregular (before I was on beta-blockers and before I got my Reveal device) - enough to make me wonder if I was having runs of paroxysmal AF, but I guess that could have been AV block or even just runs of ectopics.

Take care and hopefully the woozy feeling will stay away,

Flop

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Hi Flop,

yeah that is what I was thinking too -- tachy probably just "fatigued" the AV node, making its refractory longer.....I have read that increased vagal tone can lead to mobitz I, and this would make sense in regard to refractory time. probably no biggie, but i think you're right that i should give it to my cardio anyway......the woozy sensation definitely was with the postural tachy, but continued on and symptoms of SOB and light-headedness came on after I had laid down. the tachy was pretty quick to end i must say and then the sudden two full cardiac cycles with prolonged PR's and then the third cycle followed the P with it's missing QRS, our fine and dandy mobitz I ............interestingly enough, the P wave morphology DID change, during mobitz and then after mobitz in comparison to the sinus tachy that I was having while standing..........different foci points, looked like wandering atrial pacemaker to me, three different P wave morphologies in the same lead and varying R TO R's ........my cardio told me four years ago that my P wave morphology had not change from stand to supine (tachy back down) -- but this strip is telling a different story -- there's no tachy following the standing tachy, just the mobitz and then varying R to R intervals and several morphologic P wave presentations per each R wave. interesting. At first i thought maybe it was just a sinus arrhythmia, but i believe that sinus arrhythmia would present with the same P wave morphology, just varying R TO R's with respiration ....so it must be just wandering atrial pacemaker rhythm following mobitz..............

kind of weird to see all this on my OWN rhythm strip! I'm always analyzing this stuff on everyone else's rhythm strips!

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gave the strip to my cardio -- he said it looked like pots (extreme tachy) followed by mobitz I and extreme brady which basically he summed up as a vasovagal and good thing i laid down cuz i would have hit the floor. he said he doesnt know why i'm having so many vagal events as this never was an issue for me (and i sure as heck dont have an answer for him as to why! lol) .........he said there are two types of autonomic dys - pots and vagal and then there's overlap........he thinks something has changed but not sure what and said he cant wait to see what blair grubb has to say (i see grubb in december) ..........

so that is the latest.............still havent caught that flutter event yet! arggh!!

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Thanks for sharing your cardio's opinion. It would be interesting if we could really understand what goes on in out dysautonomic bodies to cause symptoms to change like yours have.

I hope you're being a "good girl" and wearing your cardio memo religiously. I wore an external loop recorder continuously 24/7 for 8 weeks in the summer a couple of years back. I was given enough electrodes to change them every third day. I would just disconnect myself, have a shower, towel dry then clip the leads back on. My skin hated having the wet gel and the glue on - I used to end up with a circle of tiny blisters when I peeled the electrodes off. I struggled to find enough skin to stick them on to let sites heal before they had another electrode applied! Glad that I've got the reveal now (although it was put in January 2006 so must be almost out of battery by now).

Flop

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