A-V dissociation: A reappraisal∗

Marriott, Henry J.L.; Schubart, Adalbert F.; Bradley, Samuel M.

doi:10.1016/0002-9149(58)90186-3

Cited by 35 publications

(2 citation statements)

References 75 publications

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“…IRD in the general population is extremely rare. It may complicate digoxin toxicity, acute posterior wall myocardial infarction and acute rheumatic fever [4]. Although not frequently commented upon in the recent literature, IRD has been reported to occur commonly under general anaesthesia, in up to 42% of patients anaesthetised with a halogenated inhalational agent [1][2]5].…”

Section: Discussionmentioning

confidence: 99%

Isorhythmic Atrioventricular Dissociation with haemodynamic instability in a patient with a pacemaker

2016

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We report probable isorhythmic atrioventricular dissociation (IRD) causing significant hypotension in a 94 year-old male with a dual chamber pacemaker undergoing a craniotomy. Poorly responsive to beta-blockade and escalating doses of vasopressors, hypotension and dysrhythmia were successfully treated with induction of asynchronous atrioventricular (AV) pacing. In patients with reduced cardiac reserve, the loss of coordinated atrial and ventricular activity, as in IRD, can substantially reduce cardiac output. In these patients, methods to restore AV synchrony should be quickly sought.

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