Third degree AV block screening
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2] Soroush Seifirad, M.D.[3] Aditya Ganti M.B.B.S. [4]
Overview
Ambulatory electrocardiographic monitoring is useful for finding intermittent atrioventricular block, LBBB and bifascicular block in asymptomatic patients. In patients with symptomatic atrioventricular block or bradycardia during sleep, screening about sleep apnea is recommended.
Screening
- Ambulatory electrocardiographic monitoring is useful for finding intermittent atrioventricular block, LBBB and bifascicular block in asymptomatic patients.
- In patients with symptomatic atrioventricular block or bradycardia during sleep, screening about sleep apnea is recommended.[1]
- Screening for congenital complete heart block is recommended in pregnant women with Ro/SSA antibodies.[2]
- Women with history of neonatal lupus, fetal echos are recommended weekly or every other week from week 18 to 28.
- It is unclear how often first degree heart block progresses to complete heart block, some cases my revert to normal sinus rhythm or complete heart block.
| Recommendations for screening sleep apnea in patients with bradycardia or conduction disorder |
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❑ Screening about sleep apnea syndrome is recommended In patients with documented or suspected bradycardia or conduction disorder during sleep |
| (Class IIa, Level of Evidence B): |
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❑ In patients with previously PPM implantation for bradycardia or conduction disorder, screening about sleep apnea syndrome is reasonable |
| The above table adopted from 2018 AHA/ACC/HRS Guideline[3] |
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References
- ↑ Kasai, Takatoshi; Floras, John S.; Bradley, T. Douglas (2012). "Sleep Apnea and Cardiovascular Disease". Circulation. 126 (12): 1495–1510. doi:10.1161/CIRCULATIONAHA.111.070813. ISSN 0009-7322.
- ↑ Clowse MEB, Eudy AM, Kiernan E, Williams MR, Bermas B, Chakravarty E; et al. (2018). "The prevention, screening and treatment of congenital heart block from neonatal lupus: a survey of provider practices". Rheumatology (Oxford). 57 (suppl_5): v9–v17. doi:10.1093/rheumatology/key141. PMC 6099126. PMID 30137589.
- ↑ Kusumoto, Fred M.; Schoenfeld, Mark H.; Barrett, Coletta; Edgerton, James R.; Ellenbogen, Kenneth A.; Gold, Michael R.; Goldschlager, Nora F.; Hamilton, Robert M.; Joglar, José A.; Kim, Robert J.; Lee, Richard; Marine, Joseph E.; McLeod, Christopher J.; Oken, Keith R.; Patton, Kristen K.; Pellegrini, Cara N.; Selzman, Kimberly A.; Thompson, Annemarie; Varosy, Paul D. (2019). "2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society". Circulation. 140 (8). doi:10.1161/CIR.0000000000000628. ISSN 0009-7322.