Third degree AV block surgery: Difference between revisions

Jump to navigation Jump to search
No edit summary
No edit summary
Line 11: Line 11:
Permanent pacemaker implantation indications in complete heart block include:
Permanent pacemaker implantation indications in complete heart block include:
* Symptomatic bradycardia (including heart failure)
* Symptomatic bradycardia (including heart failure)
* Ventricular arrhythmias presumed to be due to AV block
* Ventricular arrhythmias presumed to be due to AV block
* Awake, symptom-free patients in sinus rhythm with documented periods of asystole 3 seconds or longer
* Awake, symptom-free patients in sinus rhythm with documented periods of asystole 3 seconds or longer
* Any escape rate less than 40 beats/min
* Any escape rate less than 40 beats/min
* Escape rhythm that is below the AVN
* Escape rhythm that is below the AVN
* Asymptomatic patients with atrial fibrillation and bradycardia with 1 or more pauses of at least 5 seconds or longer
* Asymptomatic patients with atrial fibrillation and bradycardia with 1 or more pauses of at least 5 seconds or longer
* After catheter ablation of the AV junction
* After catheter ablation of the AV junction
* Postoperative complete heart block
* Postoperative complete heart block
* Average resting heart rate of over 40 beats per minute while awake in an asymptomatic patient
* Average resting heart rate of over 40 beats per minute while awake in an asymptomatic patient
* Certain neuromuscular diseases which have a high potential for unpredictable rapid progression of conduction blocks
* Certain neuromuscular diseases which have a high potential for unpredictable rapid progression of conduction blocks

Revision as of 00:20, 19 February 2013

Third degree AV block Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Third degree AV block from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X Ray

Echocardiography and Ultrasound

CT scan

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Third degree AV block surgery On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

slides

Images

American Roentgen Ray Society Images of Third degree AV block surgery

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Third degree AV block surgery

CDC on Third degree AV block surgery

Third degree AV block surgery in the news

Blogs on Third degree AV block surgery

Directions to Hospitals Treating Third degree AV block

Risk calculators and risk factors for Third degree AV block surgery

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Raviteja Guddeti, M.B.B.S. [3]

Please help WikiDoc by adding more content here. It's easy! Click here to learn about editing.

Surgery

Implantation of permanent pacemakers in both asymptomatic and symptomatic patients is usually done. Asymptomatic Mobitz II are prone to be converted to symptomatic or third degree heart AV block. Thus, they should be considered for a pacemaker even if asymptomatic.

Pacemaker Indications

Permanent pacemaker implantation indications in complete heart block include:

  • Symptomatic bradycardia (including heart failure)
  • Ventricular arrhythmias presumed to be due to AV block
  • Awake, symptom-free patients in sinus rhythm with documented periods of asystole 3 seconds or longer
  • Any escape rate less than 40 beats/min
  • Escape rhythm that is below the AVN
  • Asymptomatic patients with atrial fibrillation and bradycardia with 1 or more pauses of at least 5 seconds or longer
  • After catheter ablation of the AV junction
  • Postoperative complete heart block
  • Average resting heart rate of over 40 beats per minute while awake in an asymptomatic patient
  • Certain neuromuscular diseases which have a high potential for unpredictable rapid progression of conduction blocks

Pacing Mode

VVI pacing mode was widely used in the past. But this mode has been shown to be associated with AV dyssynchrony leading to pacemaker syndrome. A dual chamber DDD pacemaker is preferred over a single chambered VVI pacemakers as it maintains physiologic AV synchrony. A dual-chamber artificial pacemaker is a type of device that typically listens for a pulse from the SA node and sends a pulse to the AV node at an appropriate interval, essentially completing the connection between the two nodes. Pacemakers in this role are usually programmed to enforce a minimum heart rate and to record instances of atrial flutter and atrial fibrillation , two common secondary conditions that can accompany third degree AV block.

References

Template:WikiDoc Sources