Second degree AV block screening: Difference between revisions
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{{CMG}}; {{AE}} | {{CMG}}; {{AE}} | ||
==Overview== | ==Overview== | ||
There is no established screening method for [[atrioventricular block]]. | |||
==Screening== | ==Screening== | ||
*[[Ambulatory electrocardiographic monitoring]] is useful for finding intermittent [[atrioventricular block]], [[LBBB]] and [[bifascicular block]] in [[asymptomatic]] [[patients]]. | |||
* In [[patients]] with [[symptomatic]] [[atrioventricular block]] or [[bradycardia]] during [[sleep]], screening about [[sleep apnea]] is recommended.<ref name="KasaiFloras2012">{{cite journal|last1=Kasai|first1=Takatoshi|last2=Floras|first2=John S.|last3=Bradley|first3=T. Douglas|title=Sleep Apnea and Cardiovascular Disease|journal=Circulation|volume=126|issue=12|year=2012|pages=1495–1510|issn=0009-7322|doi=10.1161/CIRCULATIONAHA.111.070813}}</ref> | |||
* Screening for [[congenital]] [[complete heart block]] is recommended in [[pregnant]] [[women]] with [[SLE]] and positive anti-Ro and La (SSA and | |||
SSB) antibodies.<ref name="pmid30137589">{{cite journal| author=Clowse MEB, Eudy AM, Kiernan E, Williams MR, Bermas B, Chakravarty E et al.| title=The prevention, screening and treatment of congenital heart block from neonatal lupus: a survey of provider practices. | journal=Rheumatology (Oxford) | year= 2018 | volume= 57 | issue= suppl_5 | pages= v9-v17 | pmid=30137589 | doi=10.1093/rheumatology/key141 | pmc=6099126 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=30137589 }}</ref> | |||
*[[Women]] with [[history]] of [[neonatal lupus]], [[fetal]] echos are recommended weekly or every other week from week 18 to 28. | |||
* In such case, [[neonatal]] [[second degree heart block]] may respond to [[dexamethason]] or progresses to [[complete heart block]]. | |||
{| style="cellpadding=0; cellspacing= 0; width: 600px;" | |||
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| style="padding: 0 5px; font-size: 100%; background: #4682B4; color: #FFFFFF;" align=center |'''Recommendations for screening sleep apnea in patients with bradycardia or conduction disorder | |||
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|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |''' ([[ACC AHA guidelines classification scheme|Class I, Level of Evidence B]]):''' | |||
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|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left| | |||
❑ Screening about [[sleep apnea syndrome]] is recommended In [[patients]] with documented or suspected [[bradycardia]] or [[conduction]] disorder during [[sleep]]<br> | |||
❑ [[Continuous airway pressure]] and [[weight loss]] is recommended in [[patients]] with [[bradycardia]] or [[conduction]] disorder during [[sleep]] and documented [[obstructive sleep apnea]]<br> | |||
|- | |||
|style="font-size: 100; padding: 0 5px; background: #B8B8B8" align=left |''' ([[ACC AHA guidelines classification scheme|Class IIa, Level of Evidence B]]):''' | |||
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|style="padding: 0 5px; font-size: 100%; background: #F5F5F5; width: 70%" align=left| | |||
❑ In [[patients]] with previously [[PPM]] implantation for [[bradycardia]] or [[conduction disorder]], screening about [[sleep apnea syndrome]] is reasonable<br> | |||
<br> | |||
|} | |||
{| | |||
! 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 08:45, 24 July 2021
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
There is no established screening method for atrioventricular block.
Screening
- Ambulatory electrocardiographic monitoring is useful for finding intermittent atrioventricular block, LBBB and bifascicular block in asymptomatic patients.
- In patients with symptomatic atrioventricular block or bradycardia during sleep, screening about sleep apnea is recommended.[1]
- Screening for congenital complete heart block is recommended in pregnant women with SLE and positive anti-Ro and La (SSA and
SSB) antibodies.[2]
- Women with history of neonatal lupus, fetal echos are recommended weekly or every other week from week 18 to 28.
- In such case, neonatal second degree heart block may respond to dexamethason or progresses to complete heart block.
| Recommendations for screening sleep apnea in patients with bradycardia or conduction disorder |
| (Class I, Level of Evidence B): |
|
❑ Screening about sleep apnea syndrome is recommended In patients with documented or suspected bradycardia or conduction disorder during sleep |
| (Class IIa, Level of Evidence B): |
|
❑ In patients with previously PPM implantation for bradycardia or conduction disorder, screening about sleep apnea syndrome is reasonable |
| The above table adopted from 2018 AHA/ACC/HRS Guideline[3] |
|---|
References
- ↑ Kasai, Takatoshi; Floras, John S.; Bradley, T. Douglas (2012). "Sleep Apnea and Cardiovascular Disease". Circulation. 126 (12): 1495–1510. doi:10.1161/CIRCULATIONAHA.111.070813. ISSN 0009-7322.
- ↑ Clowse MEB, Eudy AM, Kiernan E, Williams MR, Bermas B, Chakravarty E; et al. (2018). "The prevention, screening and treatment of congenital heart block from neonatal lupus: a survey of provider practices". Rheumatology (Oxford). 57 (suppl_5): v9–v17. doi:10.1093/rheumatology/key141. PMC 6099126. PMID 30137589.
- ↑ 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.