First degree AV block medical therapy: Difference between revisions

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{{First degree AV block}}
{{First degree AV block}}
{{CMG}}; {{AE}} {{CZ}}
{{CMG}}; {{AE}} {{Sara.Zand}} [[User:Mohammed Salih|Mohammed Salih, M.D.]], {{CZ}}


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==Overview==
Commonly, there is no need for treating [[first-degree AV block]]. [[Permanent pacemaker]] indicates only for [[symptomatic]] [[first-degree AV block]] with PR>300 ms,[[neuromuscular]] [[disease]], or in presence of [[wide QRS]] compelex. [[First-degree AV block]] in the setting of [[acute myocardial infarction]] usually reverses after recovery from acute phase of [[myocardial infarction]]. [[Antiarrhythmic]] [[medications]] should be avoided in [[first-degreeAV block]].
==Medical Therapy==


==Medical Therapy==
* Commonly, there is no need for treating [[first-degree AV block]].
* Correction of reversible causes of the block such as [[ischemia]], medications, electrolyte imbalances, and vagotonic conditions should be considered.
*[[Permanent pacemaker]] indicates only for [[symptomatic]] [[first-degree AV block]] with PR>300 ms, [[neuromuscular]] [[disease]], or in  presence of [[wide QRS]] compelex.
* Treatment in emergency situations are [[atropine]] and an [[external pacer]].
* [[First-degree AV block]] in the setting of [[acute myocardial infarction]] usually reverses after recovery from [[myocardial infarction]].
* Implantation of [[permanent pacemaker]]s is not usually indicated in first degree heart block.  
* [[Antiarrhythmic]] [[medications]] should be avoided in [[first-degreeAV block]].<ref name="pmid30105427">{{cite journal |vauthors=Lewalter T, Pürerfellner H, Ungar A, Rieger G, Mangoni L, Duru F |title="First-degree AV block-a benign entity?" Insertable cardiac monitor in patients with 1st-degree AV block reveals presence or progression to higher grade block or bradycardia requiring pacemaker implant |journal=J Interv Card Electrophysiol |volume=52 |issue=3 |pages=303–306 |date=August 2018 |pmid=30105427 |doi=10.1007/s10840-018-0439-7 |url=}}</ref>
* This condition does not require admission unless there is an associated [[myocardial infarction]]. Even though it usually does not progress to higher forms of heart block, it may require outpatient follow up and monitoring of the [[EKG]] especially if there is an associated [[bundle branch block]].


==References==
==References==

Latest revision as of 05:28, 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] Mohammed Salih, M.D., Cafer Zorkun, M.D., Ph.D. [3]

Overview

Commonly, there is no need for treating first-degree AV block. Permanent pacemaker indicates only for symptomatic first-degree AV block with PR>300 ms,neuromuscular disease, or in presence of wide QRS compelex. First-degree AV block in the setting of acute myocardial infarction usually reverses after recovery from acute phase of myocardial infarction. Antiarrhythmic medications should be avoided in first-degreeAV block.

Medical Therapy

References

  1. Lewalter T, Pürerfellner H, Ungar A, Rieger G, Mangoni L, Duru F (August 2018). ""First-degree AV block-a benign entity?" Insertable cardiac monitor in patients with 1st-degree AV block reveals presence or progression to higher grade block or bradycardia requiring pacemaker implant". J Interv Card Electrophysiol. 52 (3): 303–306. doi:10.1007/s10840-018-0439-7. PMID 30105427.


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