Second degree AV block primary prevention
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:
Overview
Pacemaker implantations as a treatment for atrioventricular (AV) block are increasing worldwide. Prevention strategies for AV block are lacking because modifiable risk factors have not yet been identified.Atrioventricular (AV) block is a common reason for pacemaker implantation, and the number of pacemaker implantations is increasing.1 Atrioventricular block most commonly occurs in the absence of significant cardiac disease and is generally attributed to idiopathic fibrosis of the conduction system.2 By definition, the cause of that fibrosis remains unknown.
Primary prevention
- Pacemaker implantations as a treatment for atrioventricular (AV) block are increasing worldwide. Prevention strategies for AV block are lacking because modifiable risk factors have not yet been identified[1].
- pacemakers can usually provide adequate treatment of the symptoms of AV block, no preventive or curative strategies are currently used in clinical practice.
- pacemaker implantation can involve a risk of serious complications, such as pneumothorax, cardiac tamponade, and death[2].
- After implantation, patients require generator changes, which carry a particularly high risk of infection and resultant endocarditis[3].
- Finally, independent of these procedural complications, successful pacemaker therapy has been associated with a worse prognosis.11,12,13
A better understanding of the conditions associated with severe AV conduction disease would enable the development of prevention strategies, ideally avoiding the pacemaker-associated complications and increased use of health care resources. No previous study, to our knowledge, has reported the population-based characteristics associated with incident AV block. We therefore sought to identify risk factors for AV block, with a particular emphasis on characteristics that are known to be modifiable.
References
- ↑ Kerola T, Eranti A, Aro AL, Haukilahti MA, Holkeri A, Junttila MJ, Kenttä TV, Rissanen H, Vittinghoff E, Knekt P, Heliövaara M, Huikuri HV, Marcus GM (May 2019). "Risk Factors Associated With Atrioventricular Block". JAMA Netw Open. 2 (5): e194176. doi:10.1001/jamanetworkopen.2019.4176. PMC 6632153 Check
|pmc=value (help). PMID 31125096. - ↑ Pfeiffer D, Jung W, Fehske W, Korte T, Manz M, Moosdorf R, Lüderitz B (April 1994). "Complications of pacemaker-defibrillator devices: diagnosis and management". Am. Heart J. 127 (4 Pt 2): 1073–80. doi:10.1016/0002-8703(94)90090-6. PMID 8160583.
- ↑ Bloom H, Heeke B, Leon A, Mera F, Delurgio D, Beshai J, Langberg J (February 2006). "Renal insufficiency and the risk of infection from pacemaker or defibrillator surgery". Pacing Clin Electrophysiol. 29 (2): 142–5. doi:10.1111/j.1540-8159.2006.00307.x. PMID 16492298.