Paroxysmal AV block Initial Approach

Overview

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).

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)".

Initial approach - "ESC Guidelines on Syncope (Diagnosis and Management of)".

2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Approach to AV Block

Initial Approach to AV Block -