Third degree AV block medical therapy: Difference between revisions
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==Overview== | ==Overview== | ||
Correction of reversible causes of the block such as [[ischemia]], medications (beta- | Correction of reversible causes of the block such as [[ischemia]], medications ([[beta-blocker]]s, [[calcium channel blocker]]s, [[antiarrhythmics]], and [[digoxin]]), and vagotonic conditions should be considered. Treatment may also include medicines to control [[blood pressure]] and [[atrial fibrillation]], as well as lifestyle and dietary changes to reduce [[risk factor]]s associated with [[heart attack]] and [[stroke]]. Treatment in emergency situations are [[atropine]] and an [[external pacer]]. A new third degree AV block is an emergency. | ||
A patient with inferior wall myocardial infarction and distal high grade complete heart block with a heart rate of more than 60 beats per minute is at immediate danger of asystole and requires an immediate placement of permanent pacemaker compared to a patient with inferior myocardial infarction and complete block at the level of AV node with a heart rate of 35-40 beats per minute. | A patient with inferior wall [[myocardial infarction]] and distal high grade complete heart block with a heart rate of more than 60 beats per minute is at immediate danger of [[asystole]] and requires an immediate placement of permanent [[pacemaker]] compared to a patient with inferior myocardial infarction and complete block at the level of AV node with a heart rate of 35-40 beats per minute. | ||
[[Atropine]] can partially or completely restore conduction through the [[AV node]] when the cause for complete heart block is acute [[myocardial infarction]] ([[ischemia]] of the AV node). Atropine, in this setting, reverses the reduced conduction across the AV node (which is due to increased vagal tone). | [[Atropine]] can partially or completely restore conduction through the [[AV node]] when the cause for complete heart block is acute [[myocardial infarction]] ([[ischemia]] of the AV node). Atropine, in this setting, reverses the reduced conduction across the AV node (which is due to increased vagal tone). | ||
Revision as of 23:08, 18 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]
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Overview
Correction of reversible causes of the block such as ischemia, medications (beta-blockers, calcium channel blockers, antiarrhythmics, and digoxin), and vagotonic conditions should be considered. Treatment may also include medicines to control blood pressure and atrial fibrillation, as well as lifestyle and dietary changes to reduce risk factors associated with heart attack and stroke. Treatment in emergency situations are atropine and an external pacer. A new third degree AV block is an emergency.
A patient with inferior wall myocardial infarction and distal high grade complete heart block with a heart rate of more than 60 beats per minute is at immediate danger of asystole and requires an immediate placement of permanent pacemaker compared to a patient with inferior myocardial infarction and complete block at the level of AV node with a heart rate of 35-40 beats per minute.
Atropine can partially or completely restore conduction through the AV node when the cause for complete heart block is acute myocardial infarction (ischemia of the AV node). Atropine, in this setting, reverses the reduced conduction across the AV node (which is due to increased vagal tone).