Paroxysmal AV block
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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
- Paroxysmal AV block is defined as a delayed escape rhythm which repetitively blocks conduction from the atria to the ventricles, thereby causing syncope, conduction defects such as asystole and sudden cardiac death.
- It may or may not be associated with Phase 3 or Phase 4 conduction defects.
- It may be due to an increased vagal tone, innately low adenosine levels or an intrinsic conduction defect, all of which lead to different ECG presentations.
- Insufficient data is available regarding the exact etiology, diagnostic study of choice and treatment of paroxysmal AV blocks.
- It can be thought of more as a disease of exclusion. However,efforts must be made to have a standardized approach to such patients.
Historical Perspective
Classification
Pathophysiology
Intrinsic AV Block | Extrinsic Vagal AV Block | Extrinsic Idiopathic AV Block
Epidemiology and Etiology
Differentiating Paroxysmal AV Block from other Diseases
Natural History, Complications and Prognosis
Diagnosis
Initial Approach | History and Symptoms | Electrocardiogram, Holter Monitoring, External Loop Recorder | Implantable Loop Recorder | Electrophysiologic studies | Vagal Maneuvers,Carotid Sinus Massage and Tilt Table testing | Laboratory Findings and Stimulation tests | Diagnostic Summary Table |
Treatment
Cardiac Pacing |Treatment for Reflex Syncope|Theopylline |