Paroxysmal AV Block echocardiography

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Akash Daswaney, M.B.B.S[2]

Overview

Echocardiography has a highler yield where diagnosing syncope and presyncope is concerned, in patients with structural heart disease.

Echocardiography

2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Recommendations for Cardiac Imaging

Recommendations for Cardiac Imaging
"1. In patients with newly identified LBBB, seconddegree Mobitz type II atrioventricular block,high-grade atrioventricular block, or hirddegree atrioventricular block with or without apparent structural heart disease or coronary artery disease, transthoracic echocardiography is recommended. (Level of Evidence: B-NR[1]

2. In selected patients presenting with bradycardia or conduction disorders other than LBBB, second-degree Mobitz type II atrioventricular block, high-grade atrioventricular block, or third-degree atrioventricular block, transthoracic echocardiography is reasonable if structuralheart disease is suspected. (Level of Evidence: B-NR)[1]

3. In selected patients with bradycardia or bundle branch block, disease-specific advanced imaging (eg, transesophageal echocardiography, computed tomography,cardiac magnetic resonance imaging [MRI], or nuclear imaging) is reasonable if structural heart disease is suspected yet not confirmed by other diagnostic modalities. (Level of Evidence: C-LD)[1]

4. In the evaluation of patients with asymptomatic sinus bradycardia or firstdegree atrioventricular block and no clinical evidence of structural heart disease, routine cardiac imaging is not indicated. (Level of Evidence: B-NR)[1]"

References

  1. 1.0 1.1 1.2 1.3 1.4 Kusumoto FM, Schoenfeld MH, Barrett C, Edgerton JR, Ellenbogen KA, Gold MR; et al. (2019). "2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines, and the Heart Rhythm Society". J Am Coll Cardiol. 74 (7): 932–987. doi:10.1016/j.jacc.2018.10.043. PMID 30412710.


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