Paroxysmal AV block Electrocardiogram: Difference between revisions
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(Created page with "==Electrocardiogram, Holter monitoring, External Loop Recorder== *According to the '''European Society of Cardiology''', indications for ECG monitoring are as follows : *#Imm...") |
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==Electrocardiogram, Holter monitoring, External Loop Recorder== | ==Electrocardiogram, Holter monitoring, External Loop Recorder== | ||
*According to the '''European Society of Cardiology''', indications for ECG monitoring are as follows : | *According to the '''European Society of Cardiology''', indications for ECG monitoring are as follows : | ||
*#Immediate in-hospital monitoring (in bed or by telemetry) is indicated in high risk patients. | *#'''Immediate in-hospital monitoring (in bed or by telemetry)''' is indicated in high risk patients. | ||
*#Holter monitoring should be considered in patients who have frequent syncope or presyncope (more than or equal to 1 episode per week). | *#'''Holter monitoring''' should be considered in patients who have frequent syncope or presyncope (more than or equal to 1 episode per week). | ||
*#External loop recorders should be considered, early after the index event, in patients who have an inter symptom interval of less than or equal to 4 weeks. {{cite web |url=https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Syncope-Guidelines-on-Diagnosis-and-Management-of |title=ESC Guidelines on Syncope (Diagnosis and Management of) |format= |work= |accessdate=}} | *#'''External loop recorders''' should be considered, early after the index event, in patients who have an inter symptom interval of less than or equal to 4 weeks. {{cite web |url=https://www.escardio.org/Guidelines/Clinical-Practice-Guidelines/Syncope-Guidelines-on-Diagnosis-and-Management-of |title=ESC Guidelines on Syncope (Diagnosis and Management of) |format= |work= |accessdate=}} | ||
Classic ECG Findings seen in the different types of paroxysmal AV Block are as follows : | Classic ECG Findings seen in the different types of paroxysmal AV Block are as follows : | ||
Revision as of 06:23, 15 June 2020
Electrocardiogram, Holter monitoring, External Loop Recorder
- According to the European Society of Cardiology, indications for ECG monitoring are as follows :
- Immediate in-hospital monitoring (in bed or by telemetry) is indicated in high risk patients.
- Holter monitoring should be considered in patients who have frequent syncope or presyncope (more than or equal to 1 episode per week).
- External loop recorders should be considered, early after the index event, in patients who have an inter symptom interval of less than or equal to 4 weeks. "ESC Guidelines on Syncope (Diagnosis and Management of)".
Classic ECG Findings seen in the different types of paroxysmal AV Block are as follows :
- The SYNARR- Flash study (Monitoring of SYNcopes and/or sustained palpitations of suspected ARRhythmic origin) was one of the first multicentric observational studies wherein 395 patients with a history of unexplained syncope were monitored with an external ECG device for 4 weeks.
- Based on certain criteria, events were classified as conclusive, significant, suggestive and negative.
- It was found that diagnostic events were seen more in patients in which ECG recordings were initiated within 15 days from the index syncope and those with a history of supraventricular arrhythmias and frequent events. If the patient remained undiagnosed following this 4 week interval, more invasive modalities like implantable loop recorders (ILR) may be considered. [1]
- Brignole et al demonstrated that bundle branch block findings on an ECG does not necessarily correlate to a cardiac related/ bradyarrhythmic syncope.
- Bundle branch block (in particular, a monofasicular block) in a patient with atypical presenting symptoms and advancing age should prompt a physician to think of paroxysmal AV block or a neutrally mediated mechanism being behind the syncope.[2]
- ↑ Locati ET, Moya A, Oliveira M, Tanner H, Willems R, Lunati M; et al. (2016). "External prolonged electrocardiogram monitoring in unexplained syncope and palpitations: results of the SYNARR-Flash study". Europace. 18 (8): 1265–72. doi:10.1093/europace/euv311. PMC 4974630. PMID 26519025.
- ↑ Donateo P, Brignole M, Alboni P, Menozzi C, Raviele A, Del Rosso A; et al. (2002). "A standardized conventional evaluation of the mechanism of syncope in patients with bundle branch block". Europace. 4 (4): 357–60. doi:10.1053/eupc.2002.0265. PMID 12408253.