Paroxysmal AV block: Difference between revisions

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Revision as of 07:14, 15 June 2020

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S [2]

Synonyms and keywords:

Overview

Historical Perspective

Historical Perspective | Famous cases

Classification

Classification Based on Cause

Pathophysiology

Intrinsic AV Block | Extrinsic Vagal AV Block | Extrinsic Idiopathic AV Block

Causes

Differentiating Paroxysmal AV block from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Diagnosis

Treatment

Cardiac Pacing |Treatment for Reflex Syncope|Theopylline |

Case Studies

Case #1

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 [[Paroxysmal AV Block Intrinsic AV Block|Intrinsic AV Block]] | [[Paroxysmal AV Block Extrinsic Vagal AV Block|Extrinsic Vagal AV Block]] | [[Paroxysmal AV Block Extrinsic Idiopathic AV Block|Extrinsic Idiopathic AV Block]]
-==Extrinsic Idiopathic AV Block==
-*The pathogenesis of extrinsic idiopathic paroxysmal AV block (EI-AVB) can be correlated to ''' adenosine plasma levels (APL) and increased affinity of adenosine A1 receptors'''.
-*There is a recurrent history of unexplained syncope, absence of ECG and cardiac abnormalities and a good prognosis.
-*Due to innately low APL values seen in these patients, there is '''an upregulation of A1 receptors''', such that even during a mild transient surge in endogenous adenosine levels, AV block occurs.
-*A1 receptors, which are present more in the AV node than the SA node, impose an '''antiadrenergic action''' by antagonizing β1 receptors, the sympathetic nervous system, hyperpolarizing the SA and AV nodes through potassium channels and lowering intracellular cAMP levels. <ref name="pmid26115830">{{cite journal| author=Brignole M, Deharo JC, Guieu R| title=Syncope and Idiopathic (Paroxysmal) AV Block. | journal=Cardiol Clin | year= 2015 | volume= 33 | issue= 3 | pages= 441-7 | pmid=26115830 | doi=10.1016/j.ccl.2015.04.012 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=26115830  }} </ref>
-*Therefore, in such patients an injection of adenosine or adenosine triphosphate (ATP) may reproduce the attack and adenosine antagonists such as theophylline may be an efficacious treatment option.
-*On an ECG, there is an absence of signs of vagal stimulation, atrial/ventricular premature beats and there may be a presence of narrow QRS complexes prior to the period of complete AV Block/ asystole
-*Certain studies have also noticed '''genetic polymorphisms in A2A receptors''' in a population of people experiencing recurrent unexplained syncope.<ref name="pmid19386617">{{cite journal| author=Saadjian AY, Gerolami V, Giorgi R, Mercier L, Berge-Lefranc JL, Paganelli F | display-authors=etal| title=Head-up tilt induced syncope and adenosine A2A receptor gene polymorphism. | journal=Eur Heart J | year= 2009 | volume= 30 | issue= 12 | pages= 1510-5 | pmid=19386617 | doi=10.1093/eurheartj/ehp126 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19386617  }} </ref>
 ==[[Paroxysmal AV block causes|Causes]]==

Paroxysmal AV block: Difference between revisions

Revision as of 07:14, 15 June 2020

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