Third degree AV block screening: Difference between revisions
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There is insufficient evidence to recommend routine screening for third degree AV block. However, screening for congenital AV block is recommended. | There is insufficient evidence to recommend routine screening for third degree AV block. However, screening for congenital AV block is recommended. | ||
==Screening== | ==Screening== | ||
==Screening== | |||
*[[Ambulatory electrocardiographic monitoring]] is useful for detection of 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> | |||
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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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❑ 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> | |||
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|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> | |||
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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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*There is insufficient evidence to recommend routine screening for third degree AV block. However, screening for congenital AV block is recommended. | *There is insufficient evidence to recommend routine screening for third degree AV block. However, screening for congenital AV block is recommended. | ||
Revision as of 07:25, 24 July 2021
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Third degree AV block Microchapters | |
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Soroush Seifirad, M.D.[2] Aditya Ganti M.B.B.S. [3]
Overview
There is insufficient evidence to recommend routine screening for third degree AV block. However, screening for congenital AV block is recommended.
Screening
Screening
- Ambulatory electrocardiographic monitoring is useful for detection of 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]
| 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[2] |
|---|
- There is insufficient evidence to recommend routine screening for third degree AV block. However, screening for congenital AV block is recommended.
- Recommendations include echocardiogram for newborns of pregnant women with SSA autoantiboides.
- Timing for screening:[3]
- Women with history of neonatal lupus, fetal echos are recommended weekly then repeating the echos every 3 or 4 weeks.
- Women with prior infant with lupus, echos are performed at the 16 weeks of gestation or 18 weeks.
- Fetal echos can be stopped by the 23 weeks of gestation.
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.
- ↑ 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.
- ↑ 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.