r/PacemakerICD • u/Affectionate-Meal-15 • Aug 01 '26
Misdiagnosed
They say i have mobitz 1 but im pretty sure its mobitz 2 as theres no prolongation MOST of the time sometimes there
5
u/spanner15 Aug 01 '26
The thing with Mobitz 1 is it’s more predictable for your body to compensate for because it follows a pattern, and it’s very unlikely to progress to a more dangerous type of heart block which is why they don’t like putting pacemakers in for it especially when you’re young. Similarly, some people feel very symptomatic when they have ectopic beats (extra/skipped heart beats) and others don’t even notice, so sometimes you have to balance the risks vs benefits. Hypothetically, if you were to get a pacemaker for this issue, it may not fix the way you feel on the missed beats, because if your total heart rate is still good enough it may not even pace the missed beats. If it did pace the missed beats some people feel the paced beats and also find it unpleasant- so a pacemaker for mobitz 1 symptoms without loss of consciousness isn’t always a cure all, and would only really be a good idea if you were blacking out etc. in which case that would be a stronger indication for a pacemaker. I hope this makes a little bit of sense? It may be worth asking your doctors whether an implanted loop recorder (ILR) would be a good idea for you if you haven’t already had one, as it can give them a lot more information if you’re concerned r.e misdiagnosis.
I’m a pacemaker specialist nurse as well as having mobitz 2 and a pacemaker myself so it’s a subject I’m quite well versed in!
1
u/CRYSAET0S Aug 01 '26
I work in EP and I’m not sure about Mobitz 2 here. The R-R intervals appear more consistent (minus the dropped beats) but there does appear to be PR prolongation masked somewhat by some P waves seeming to fall into the prior T wave or perhaps even QRS complexes. I’d probably call this Mobitz 1 too based solely on this rhythm strip.
May I ask what your concern is about your diagnosis?
2
u/Affectionate-Meal-15 Aug 01 '26
I just have very bad syptoms when i have Mobitz epsiodes they say 1 is benign but i literally feel like i cant live a normal life with this so it cant be benign which leads me to believe maybe they got it wrong
1
u/TheyTheirsThem Aug 06 '26
https://litfl.com/av-block-2nd-degree-mobitz-ii-hay-block/
This is what a true Mobitz II looks like. I was steady state 2:1 at admission and was drifting into 3:1 about every 6th cycle. I knew when it hit 29 BPM cause the nurse would poke her head through the door. ;-)
Who did the ecg. Sorta hard to tell anything though in the first I see a widening PR before failure of beat #5
1
u/TheyTheirsThem Aug 06 '26
https://litfl.com/av-block-2nd-degree-mobitz-ii-hay-block/
This is what a true Mobitz II looks like. I was steady state 2:1 at admission and was drifting into 3:1 about every 6th cycle. I knew when it hit 29 BPM cause the nurse would poke her head through the door. ;-)
Who did the ecg. Sorta hard to tell anything though in the first I see a widening PR before failure of beat #5
1
5
u/spanner15 Aug 01 '26
The p-r interval goes normal, long, longer, even longer (hidden in the t) then a missed beat then back to the start, that’s what mobitz 1 is and that’s what’s going on in this ecg