Third degree AV block other imaging findings

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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]

Overview

Nuclear imaging techniques might rarely used and may be helpful in the diagnosis of complications of third degree AV block or provide shreds of evidence in favor of the underlying disease in those with compete heart block.

Other Imaging Findings

Recommendation for cardiac imaging for management of bradycardia associated atrioventricular block

Transthoracic echocardiography (Class I , Level of Evidence B):

❑Transthoracic echocardiography is recommended in patients with newly identified LBBB, Second-degree mobitz type2 AV block, high grade AV block, third-degree AV block with or without diagnosed structural heart disease or coronary artery disease

Exercise treadmill test (Class IIa , Level of Evidence C):

❑ Exercise treadmill test is reasonable in patients with first degree AV block or mobitz type 1 second degree AV block in resting ECG who have chest pain or shortness of breath during exercise to identify the benefit of permanent pacing

Electrophysiologic study (Class IIb , Level of Evidence B):

❑EPS may be considered in selective patients with second degree AV block to determine the level of block

Pharmacologic challenge tests (Class IIb , Level of Evidence C):

❑Atropine, procainamide, isoproternole, carotide sinus massage may be used in selected patients with second degree AV block to determine the level of block and benefit from permanent pacing

The above table adopted from 2018 AHA/ACC/HRS Guideline