Paroxysmal AV block Initial Approach
Initial Approach
- The pathway to conclusively diagnosing a patient with paroxysmal AV block is not straightforward.
- Since most patients present with a history of recurrent unexplained syncope and fortuitous timing would be required to document classical ECG findings during an acute episode, it would be best to treat it as a diagnosis of exclusion.
- An initial evaluation strategy of taking a detailed history, physical examination, risk stratification, ECG recording and BP measurement should help decide what investigations should be ordered (based on whether the syncope is cardiac related, reflex/neutrally mediated, secondary to cerebrovascular disease or due to orthostatic hypotension). "ESC Guidelines on Syncope (Diagnosis and Management of)".