High-grade atrioventricular block

Lim, Yinghao; Singh, Devinder; Poh, Kian Keong

doi:10.11622/smedj.2018086

Cited by 14 publications

(10 citation statements)

References 10 publications

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“…Therefore, whenever a patient with atrial flutter presents with very slow ventricular rate and regularisation of the R-R interval, the clinician should examine the ECG closely for the presence of underlying high-grade AV block (high-grade second-degree heart block or complete heart block). (5) In patients with atrial flutter, complete heart block is suspected if the heart rate becomes very slow, as demonstrated in Case 1. Similarly, the presence of complete heart block should be suspected in patients with atrial fibrillation who present with regularisation of the R-R interval.…”

Section: Discussionmentioning

confidence: 99%

Electrocardiography findings in right ventricular apical pacing

Shen

Sia

Poh

et al. 2020

smedj

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Section: Discussionmentioning

confidence: 99%

Electrocardiography findings in right ventricular apical pacing

Shen

Sia

Poh

et al. 2020

smedj

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“…8 In addition to RCA occlusion, there are several mechanisms which could lead to a conduction disorder in acute MIs: (1) Increased vagal tone; (2) Systemic hypoxia; (3) Electrolyte disturbance, such as hyperkalemia which occurred in this patient; (4) Increased local adenosine; and (5) Acid-base balance disturbance (metabolic acidosis). 9 In patients with acute inferior infarct secondary to an occluded RCA, immediate restoration of arterial perfusion may lead to improvement of the complete AV block. Reperfusion should not be delayed in patients with acute MI and complete AV block.…”

Section: Discussionmentioning

confidence: 99%

Dopamine and epinephrine for managing complete atrioventricular block due to nonreperfused acute inferior wall myocardial infarction in a rural hospital: A case report

Sandjojo

Jaury

Astari

et al. 2021

SAGE Open Medical Case Reports

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Inferior wall myocardial infarction occurs in approximately 50% of all myocardial infarctions. The most common conduction disorder of this disease is complete atrioventricular block. Immediate attention must be given to the myocardial infarction patients with conduction block due to the increased mortality rate in these patients. Temporary pacemaker implantation and permanent pacemaker implantation are recommended in complete atrioventricular block cases that do not improve with reperfusion. In this case report, a 64-year-old-female patient came to the emergency department of a rural General Hospital with complaints of epigastric pain, dizziness, nausea, and vomiting for 2 days before admission. She had uncontrolled hypertension without a history of diabetes mellitus, dyslipidemia, smoking, or a family history of heart disease. The electrocardiogram displayed an acute inferior wall myocardial infarction and complete atrioventricular block with escape junctional rhythm with a heart rate of 17 bpm. She was diagnosed with nonreperfused inferior wall myocardial infarction and a complete atrioventricular block. She was successfully treated with only dopamine and epinephrine as the definitive treatment because the patient refused to be referred to a tertiary hospital for percutaneous coronary intervention and pacemaker implantation due to financial reasons. Dopamine and epinephrine may be considered for complete atrioventricular block if transfer to a higher level of care is not feasible and as bridge therapy while waiting for transfer.

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“…A significant reduction in heart rate in patients who have previously been diagnosed with tachyarrhythmias in the form of AF with RVR may indicate not only inadequate therapy and the development of side effects of drugs used for HR control (for example, beta-blockers), but also the development of a concomitant lesions of the heart conduction system [9]. With the development of these disorders and the localization of the substituting non-sinus pacemaker near the AV node, the level of VR becomes regular and correlates within 50-60 beats/min, which against the background of the RVR form of AF with its characteristic signs (feeling of palpitations, interruptions in cardiac activity, chest discomfort) may be considered by the patient, and even by the doctor, as a restored sinus rhythm as in our clinical case.…”

Section: Discussionmentioning

confidence: 99%

Diagnosis difficulties in elderly patients with atrial fibrillation and complete atrioventricular block

Shop

Holubkina²,

Tykhonova

et al. 2021

Patologìâ

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The association of atrial fibrillation (AF) with complete atrioventricular block (CAVB) is a common clinical feature in elderly patients. It is characterized by the loss of specific symptoms of AF (palpitations, intermissions); in the first place may come CAVB symptoms: dizziness, Morgagni–Adams–Stokes (MAS) attacks. Aim. The article objective is to illustrate the dynamic changes in the course of AF with the development of CAVB on the example of a clinical case and to discuss the difficulties in timely diagnosis and therapy correction. Case presentation. A 75-year-old male was diagnosed with a rapid ventricular response form of AF. The onset of CAVB caused the transition from rapid ventricular response form of AF to slow ventricular response form, which was initially accompanied by a subjective improvement in the patient’s condition. As the disease progressed, the patient’s condition worsened due to the development of MAS attacks. The elderly patients with a permanent form of AF require constant cardiac monitoring by an experienced specialist who has appropriate vigilance in management of patients with arrhythmias, awareness about possible concomitant conduction disorders. This provides comprehensive cardiac support, including timely pacemaker implantation which gives more options for AF symptoms monitoring and heart rate control, has a positive modifying effect on drug therapy. Conclusions. Changes in the clinical picture of AF after development of CAVB can lead to late diagnosis of CAVB, inadequate therapy and untimely pacemaker implantation, as a consequence, to progression of concomitant pathology and the development of life-threatening complications, as in our clinical case.

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High-grade atrioventricular block

Cited by 14 publications

References 10 publications

Electrocardiography findings in right ventricular apical pacing

Electrocardiography findings in right ventricular apical pacing

Dopamine and epinephrine for managing complete atrioventricular block due to nonreperfused acute inferior wall myocardial infarction in a rural hospital: A case report

Diagnosis difficulties in elderly patients with atrial fibrillation and complete atrioventricular block

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