Management for first-degree AV block or Mobitz I (Wenckebach) is to:

• A. Observe
• B. Pacemaker
• C. Atropine
• D. Vagal maneuvers

Answer: (A)

At heart, these AV nodal blocks are typically benign when the patient is stable and asymptomatic. First-degree block simply means a prolonged PR interval, and Mobitz I (Wenckebach) involves progressive lengthening of the PR interval until a beat is dropped, but overall conduction at rest is usually adequate and well tolerated. Because of that, the best approach is to observe and monitor, looking for any development of symptoms, signs of decreased perfusion, or progression to a higher-grade block. If there are signs of instability or persistent symptoms, or if there’s progression or an underlying reversible cause (like electrolyte disturbance, ischemia, or drug effect), management would be adjusted accordingly, potentially with pacing if needed. In the meantime, therapies like pacemakers are not indicated for typical Mobitz I or simple first-degree blocks, and agents such as atropine or vagal maneuvers are not pursued as long-term solutions for these specific blocks; they may only serve as temporary measures in acute, symptomatic bradycardia while addressing the underlying issue.