Woldemar Mobitz

Biography

• Born 31 May 1889 St. Petersburg, Russia – the son of a prominent surgeon
• 1908 – Medical School, University of Freiburg in Breisgau
• 1914 – Graduated from the University of Munich, having transferred during his studies
• 1921 – Lecturer in the first medical clinic at the University of Munich, directed by Professor Ernst von Romberg
• 1923 – spoke at the Medical Convention for Internal Medicine in Vienna about the nature of time intervals between atrial and ventricular action
• 1923 – lectured on AV conduction disturbances in humans at the meeting of the Association of Munich Specialists of Internal Medicine – this was the occasion on which he first classified second-degree AV block into type I and II
• 1924 – Published his classic article on ‘partial block of AV conduction in human hearts‘
• 1925 – Professor and Chief Resident at the Internal Medicine Clinic in Freiburg
• 1928 – Faculty at the University of Freiburg, becoming tenured in 1939
• 1934 – Senior Assistant Physician in Freiburg
• 1943-1945 Director of the State Medical Clinic in Magdeburg
• 1946 – Returned to the University of Freiburg, where he remained until his death
• Died 11 April 1951

Key Medical Attributions

• Mobitz applied a mathematical approach to analyzing arrhythmias by graphing the relationship of changing atrial rates and premature beats to AV conduction.
• In 1924 he classified second-degree atrioventricular (AV) block into 2 principle types, subsequently referred to as Mobitz type I (Wenckebach) and Mobitz type II (Hay).
• He commented on the fact that second degree type I conduction impairment was reversible, with autopsies not normally disclosing significant AV node or His bundle disease
• Conversely, he noted that the less common type II block often progresses to complete AV block and is associated with Stokes-Adams attacks and death. Mobitz believed that type II conduction diseases were likely ‘an expression of a structural injury to the bundle’
• Published articles on a variety of topics including congenital and acute porphyria; primary pulmonary arteriosclerosis; action potential enhancement; a valve for mechanical production of alveolar air; correlation of respiration, circulation, and oxygen consumption during physical work and the uses of isotopes in medicine

Medical Eponyms

• Second-degree Atrioventricular block – Mobitz Classification; Mobitz type I (Wenckebach) and Mobitz type II (Hay)
• Woldemar-Mobitz-Forschungspreis – rhythmology research award presented by the Deutsche Gesellschaft für Kardiologie

Controversies

In 1934 Mobitz became the head of the Freiburg clinic, only to be replaced ten days later by Otto Bickenbach, a leader of the National Socialist Party in Munich. The reasons for this are uncertain

Reservations about his health led to quarrels with fellow staff member Siegrfried Josef Thannhauser, who opposed Mobitz being promoted

Notable quotable

It may appear astonishing to the clinician that the results presented here are seemingly based purely on mathematical considerations. However, the idea that all theoretical concepts of rhythm disturbances developed so far are derived from measuring the recorded tracings, and correlating numerical data will give the same approval for this method of reasoning in regard to the field of clinical medicine as it has already been given for the methods of pure chemistry and physics in regard to other fields

Mobitz 1924

Major Publications

• Mobitz W. Über die unvollständige Störung der Erregungs-überleitung zwischen Vorhof und Kammer des menschlichen Herzens. [On the partial block of impulse conduction between atrium and ventricle of human hearts] Zeitschrift Fur Die Gesamte Experimentelle Medizin. 1924;41:180-237 [Mobitz Blocks]
• Mobitz W. Fortsetzung der Aussprache über seltenere Electrokardiogramme und Demonstrationen von solchen [Discussion of rare electrocardiograms and demonstration of them]. Münchener medizinische wochenschrift. 1922;69:333
• Mobitz W. Zur Frage der atrioventrikulären Automatie [To the question of atrioventricular automation]. Münchener medizinische wochenschrift. 1922;69:762
• Mobitz W. Über die verschiedene Entstehungsweise extrasystolischer Arhythmien beim Menschen, ein Beitrag zur Frage der Interferenz mehrerer Rhythmen. Zeitschrift Fur Die Gesamte Experimentelle Medizin. 1923;34:490-507
• Mobitz W. Die Ueberleitungsstörung am menschlichen Herzen [The disturbances of AV conduction in human hearts]. Münchener medizinische wochenschrift 1923;70:1376
• Mobitz W. Zur Frage der atrioventrikulären Automatie: Die Interferenzdissoziation [To the question of atrioventricular automation: the interference dissociation]. Deutsches Archiv für klinische Medizin. 1923; 141: 257–289.
• Mobitz W. Über den partiellen Herzblock [On partial heart block]. Zeitschrift Fur Klinische Medizin 1928;107:449–462
• Mobitz W. Neueres über Isotope und ihre Verwendung in der Medizin
• [News about isotopes and their use in medicine]. Pro Medico 1949;18:37–39

References

• Silverman ME, Upshaw CB Jr, Lange HW. Woldemar Mobitz and His 1924 Classification of Second-Degree Atrioventricular Block. Circulation. 2004 Aug 31;110(9):1162-7. [PMID 15339865]
• Heilmeyer L. Woldemar Mobitz. Deutsche medizinische Wochenschrift, 1951;76(34):1030-1031
• Barold SS, Hayes DL.Second-degree atrioventricular block: a reappraisal. Mayo Clin Proc. 2001 Jan;76(1):44-57. [PMID 11155413]
• Silverman ME, Upshaw CB Jr. Karel Frederik Wenckebach and partial atrioventricular block. ACC Curr J Rev. 2000; May-June: 13–17.
• Langendorf R, Pick A. Atrioventricular block, type II (Mobitz): its nature and clinical significance. Circulation. 1968; 38: 819–821.
• Upshaw CB Jr, Silverman ME. Woldemar Mobitz: early twentieth century expert on atrioventricular block. Clin Cardiol. 2009 Nov;32(11):E75-7 [PMID 19816971]
• Surawicz B et al. The quest for optimal electrocardiography. Tast Force I: standardization of terminology and interpretation. Am J Cardiol. 1978 Jan;41(1):130-45. [PMID 622995]
• Upshaw CB Jr, Silverman ME. Alfred Lewis Galabin and the first human documentation of atrioventricular block. Am J Cardiol. 2001 Sep 1;88(5):547-50. [PMID 11524066]
• Cadogan M. History of the Electrocardiogram. LITFL
• Cadogan M. History of Second-degree Atrioventricular block. LITFL