Paroxysmal AV Block Prognosis: Difference between revisions

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==Overview==
Prognosis of intrinsic paroxysmal AV block is more dire than extrinsic idiopathic paroxysmal AV block or extrinsic vagal paroxysmal AV block.
*Given the presence of an innate structural defect, there is an '''increase risk of progression to complete AV Block in patients with intrinsic AV block. Sparse literature suggest some correlation between length of asystole and increased severity.'''  <ref name="pmid19632639">{{cite journal| author=Lee S, Wellens HJ, Josephson ME| title=Paroxysmal atrioventricular block. | journal=Heart Rhythm | year= 2009 | volume= 6 | issue= 8 | pages= 1229-34 | pmid=19632639 | doi=10.1016/j.hrthm.2009.04.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19632639  }} </ref>
*Given the presence of an innate structural defect, there is an '''increase risk of progression to complete AV Block in patients with intrinsic AV block. Sparse literature suggest some correlation between length of asystole and increased severity.'''  <ref name="pmid19632639">{{cite journal| author=Lee S, Wellens HJ, Josephson ME| title=Paroxysmal atrioventricular block. | journal=Heart Rhythm | year= 2009 | volume= 6 | issue= 8 | pages= 1229-34 | pmid=19632639 | doi=10.1016/j.hrthm.2009.04.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19632639  }} </ref>
* Given that extrinsic vagally mediated AV block is not associated with an innate conduction defect (seen in intrinsic paroxysmal AV block) and is at the level of the AV node, it is considered benign. <ref name="pmid23286970">{{cite journal| author=Alboni P, Holz A, Brignole M| title=Vagally mediated atrioventricular block: pathophysiology and diagnosis. | journal=Heart | year= 2013 | volume= 99 | issue= 13 | pages= 904-8 | pmid=23286970 | doi=10.1136/heartjnl-2012-303220 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23286970  }} </ref>
* Given that extrinsic vagally mediated AV block is not associated with an innate conduction defect (seen in intrinsic paroxysmal AV block) and is at the level of the AV node, it is considered benign. <ref name="pmid23286970">{{cite journal| author=Alboni P, Holz A, Brignole M| title=Vagally mediated atrioventricular block: pathophysiology and diagnosis. | journal=Heart | year= 2013 | volume= 99 | issue= 13 | pages= 904-8 | pmid=23286970 | doi=10.1136/heartjnl-2012-303220 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23286970  }} </ref>
*Given the absence of structural heart disease, the paroxysmal nature of the episodes and the low probability of progression into more severe forms of AV block, extrinsic idiopathic AV block has a good prognosis. <ref name="pmid28496928">{{cite journal| author=Guerrero-Márquez FJ, Arana-Rueda E, Pedrote A| title=Idiopathic Paroxysmal Atrio-Ventricular Block. What is The Mechanism? | journal=J Atr Fibrillation | year= 2016 | volume= 9 | issue= 3 | pages= 1449 | pmid=28496928 | doi=10.4022/jafib.1449 | pmc=5368548 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28496928  }} </ref>
*Given the absence of structural heart disease, the paroxysmal nature of the episodes and the low probability of progression into more severe forms of AV block, extrinsic idiopathic AV block has a good prognosis. <ref name="pmid28496928">{{cite journal| author=Guerrero-Márquez FJ, Arana-Rueda E, Pedrote A| title=Idiopathic Paroxysmal Atrio-Ventricular Block. What is The Mechanism? | journal=J Atr Fibrillation | year= 2016 | volume= 9 | issue= 3 | pages= 1449 | pmid=28496928 | doi=10.4022/jafib.1449 | pmc=5368548 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=28496928  }} </ref>
==References==

Revision as of 21:18, 27 June 2020

Overview

Prognosis of intrinsic paroxysmal AV block is more dire than extrinsic idiopathic paroxysmal AV block or extrinsic vagal paroxysmal AV block.

  • Given the presence of an innate structural defect, there is an increase risk of progression to complete AV Block in patients with intrinsic AV block. Sparse literature suggest some correlation between length of asystole and increased severity. [1]
  • Given that extrinsic vagally mediated AV block is not associated with an innate conduction defect (seen in intrinsic paroxysmal AV block) and is at the level of the AV node, it is considered benign. [2]
  • Given the absence of structural heart disease, the paroxysmal nature of the episodes and the low probability of progression into more severe forms of AV block, extrinsic idiopathic AV block has a good prognosis. [3]

References

  1. Lee S, Wellens HJ, Josephson ME (2009). "Paroxysmal atrioventricular block". Heart Rhythm. 6 (8): 1229–34. doi:10.1016/j.hrthm.2009.04.001. PMID 19632639.
  2. Alboni P, Holz A, Brignole M (2013). "Vagally mediated atrioventricular block: pathophysiology and diagnosis". Heart. 99 (13): 904–8. doi:10.1136/heartjnl-2012-303220. PMID 23286970.
  3. Guerrero-Márquez FJ, Arana-Rueda E, Pedrote A (2016). "Idiopathic Paroxysmal Atrio-Ventricular Block. What is The Mechanism?". J Atr Fibrillation. 9 (3): 1449. doi:10.4022/jafib.1449. PMC 5368548. PMID 28496928.