First degree AV block other diagnostic studies: Difference between revisions
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{{First degree AV block}} | {{First degree AV block}} | ||
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==Overview== | ==Overview== | ||
The presence of severe [[first-degree atrioventricular block]] (PR >0.30 s) and a narrow [[QRS]] usually indicates [[atrioventricular node]] delay. However, [[ambulatory]] [[ECG]] monitoring is useful for finding the alternative changes in [[QRS]] morphology. In addition, [[exercise stress test]] can be used to identify the [[ischemia]] as the precursor of the development of [[atrioventricular block]]. | |||
==Other diagnostic studies== | ==Other diagnostic studies== | ||
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| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center |'''Additional testing for management of bradycardia associated atrioventricular block''' | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[ Ambulatory electrocardiographic monitoring]] ([[ACC AHA guidelines classification scheme|Class IIa , Level of Evidence B]]):''' | |||
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❑ [[Ambulatory electrocardiographic monitoring]] is recommended in [[patients]] with [[first degree AV block]], or mobitz type 1 [[second degree AV block]] to establish the correlation between [[symptoms]] related to bradycardia ([[lightheadness]], [[syncope]]) and [[atrioventricular block]]<br> | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |''' [[Exercise treadmill test]] ([[ACC AHA guidelines classification scheme|Class IIa , Level of Evidence C]]):''' | |||
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❑ [[Exercise treadmill test]] is reasonable in [[patients]] with [[first degree AV block]] or mobitz type 1 [[second degree AV block]] in resting [[ECG]] who have [[chest pain]] or [[shortness of breath]] during [[exercise]] to identify the benefit of [[permanent pacing]]<br> | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |'''[[Electrophysiologic study]] ([[ACC AHA guidelines classification scheme|Class IIb , Level of Evidence B]]):''' | |||
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! colspan="2" style="background: PapayaWhip;" align="center" + |The above table adopted from 2018 AHA/ACC/HRS Guideline<ref name="KusumotoSchoenfeld2019">{{cite journal|last1=Kusumoto|first1=Fred M.|last2=Schoenfeld|first2=Mark H.|last3=Barrett|first3=Coletta|last4=Edgerton|first4=James R.|last5=Ellenbogen|first5=Kenneth A.|last6=Gold|first6=Michael R.|last7=Goldschlager|first7=Nora F.|last8=Hamilton|first8=Robert M.|last9=Joglar|first9=José A.|last10=Kim|first10=Robert J.|last11=Lee|first11=Richard|last12=Marine|first12=Joseph E.|last13=McLeod|first13=Christopher J.|last14=Oken|first14=Keith R.|last15=Patton|first15=Kristen K.|last16=Pellegrini|first16=Cara N.|last17=Selzman|first17=Kimberly A.|last18=Thompson|first18=Annemarie|last19=Varosy|first19=Paul D.|title=2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society|journal=Circulation|volume=140|issue=8|year=2019|issn=0009-7322|doi=10.1161/CIR.0000000000000628}}</ref> | |||
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==References== | ==References== | ||
{{Reflist|2}} | {{Reflist|2}} | ||
Latest revision as of 04:51, 24 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2]
Overview
The presence of severe first-degree atrioventricular block (PR >0.30 s) and a narrow QRS usually indicates atrioventricular node delay. However, ambulatory ECG monitoring is useful for finding the alternative changes in QRS morphology. In addition, exercise stress test can be used to identify the ischemia as the precursor of the development of atrioventricular block.
Other diagnostic studies
| Additional testing for management of bradycardia associated atrioventricular block |
| Ambulatory electrocardiographic monitoring (Class IIa , Level of Evidence B): |
|
❑ Ambulatory electrocardiographic monitoring is recommended in patients with first degree AV block, or mobitz type 1 second degree AV block to establish the correlation between symptoms related to bradycardia (lightheadness, syncope) and atrioventricular block |
| Exercise treadmill test (Class IIa , Level of Evidence C): |
|
❑ Exercise treadmill test is reasonable in patients with first degree AV block or mobitz type 1 second degree AV block in resting ECG who have chest pain or shortness of breath during exercise to identify the benefit of permanent pacing |
| Electrophysiologic study (Class IIb , Level of Evidence B): |
| The above table adopted from 2018 AHA/ACC/HRS Guideline[1] |
|---|
References
- ↑ Kusumoto, Fred M.; Schoenfeld, Mark H.; Barrett, Coletta; Edgerton, James R.; Ellenbogen, Kenneth A.; Gold, Michael R.; Goldschlager, Nora F.; Hamilton, Robert M.; Joglar, José A.; Kim, Robert J.; Lee, Richard; Marine, Joseph E.; McLeod, Christopher J.; Oken, Keith R.; Patton, Kristen K.; Pellegrini, Cara N.; Selzman, Kimberly A.; Thompson, Annemarie; Varosy, Paul D. (2019). "2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society". Circulation. 140 (8). doi:10.1161/CIR.0000000000000628. ISSN 0009-7322.