Paroxysmal AV block historical perspective: Difference between revisions
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=Famous Cases= | =Famous Cases= | ||
*In 1931, Adolph Sachs et al reported one of the first cases on paroxysmal AV block. The patient had presented with multiple spells of [[palpitations]], hot flashes, [[dizziness]], ringing in the ears, [[weakness]] and [[diaphoresis]] accompanied by [[convulsions]]. During an [[acute episode]], he noticed an irregular [[ventricular]] rhythm, irregular complexes and given a time interval of 30 seconds, the [[ventricle]] would beat once in the first 15 second window and 4-5 times in the succeeding window. It was noticed that the duration of the block progressively increased until it was present all the time. [[Mitral]] [[valvulitis]] was put down as the cause of the attack and the fact that a response to atropine does not rule out an intrinsic [[conduction defect]] was emphasized. | *'''In 1931, Adolph Sachs et al''' reported one of the first cases on paroxysmal AV block. The patient had presented with multiple spells of [[palpitations]], hot flashes, [[dizziness]], ringing in the ears, [[weakness]] and [[diaphoresis]] accompanied by [[convulsions]]. During an [[acute episode]], he noticed an irregular [[ventricular]] rhythm, irregular complexes and given a time interval of 30 seconds, the [[ventricle]] would beat once in the first 15 second window and 4-5 times in the succeeding window. '''It was noticed that the duration of the block progressively increased until it was present all the time'''. '''[[Mitral]] [[valvulitis]]''' was put down as the cause of the attack and the fact that a response to atropine does not rule out an intrinsic [[conduction defect]] was emphasized. <ref name="SachsTraynor1933">{{cite journal|last1=Sachs|first1=Adolph|last2=Traynor|first2=Raymond L.|title=Paroxysmal complete auriculo-ventricular heart-block|journal=American Heart Journal|volume=9|issue=2|year=1933|pages=267–271|issn=00028703|doi=10.1016/S0002-8703(33)90722-X}}</ref> | ||
*In 1972, Philippe Coumel et al hypothesized that the cause of [[bradycardia/]]<nowiki/>pause dependent AV block was the spontaneous [[depolarization]] of specialized conducting fibers in the late stages of [[diastole]]. It was during this ‘zone of opportunity’ that they noticed this ‘[[Atrioventricular dissociation|AV dissociation]]’. In this case, they found that the block occurred to be proximal to the division of the [[His bundle]]. | *'''In 1972, Philippe Coumel et al''' hypothesized that the cause of [[bradycardia/]]<nowiki/>pause dependent AV block was the '''spontaneous [[depolarization]] of specialized conducting fibers in the late stages of [[diastole]]. It was during this ‘zone of opportunity’ that they noticed this ‘[[Atrioventricular dissociation|AV dissociation]]’. In this case, they found that the block occurred to be proximal to the division of the [[His bundle]]'''. <ref name="pmid5113605">{{cite journal| author=Coumel P, Fabiato A, Waynberger M, Motte G, Slama R, Bouvrain Y| title=Bradycardia-dependent atrio-ventricular block. Report of two cases of A-V block elicited by premature beats. | journal=J Electrocardiol | year= 1971 | volume= 4 | issue= 2 | pages= 168-77 | pmid=5113605 | doi=10.1016/s0022-0736(71)80010-9 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=5113605 }} </ref> | ||
*In 1997. Brignole et al first described EI AVB in a group of 15 [[syncope]] patients with an initial negative work up. They fortuitously stumbled upon ECG findings indicating a paroxysmal AV block and reconfirmed this by performing an [[adenosine triphosphate test]] in each patient. | *'''In 1997. Brignole et al''' first described EI AVB in a group of 15 [[syncope]] patients with an initial negative work up. They fortuitously stumbled upon ECG findings indicating a paroxysmal AV block and reconfirmed this by performing an '''[[adenosine triphosphate test]]''' in each patient. <ref name="pmid9403616">{{cite journal| author=Brignole M, Gaggioli G, Menozzi C, Gianfranchi L, Bartoletti A, Bottoni N | display-authors=etal| title=Adenosine-induced atrioventricular block in patients with unexplained syncope: the diagnostic value of ATP testing. | journal=Circulation | year= 1997 | volume= 96 | issue= 11 | pages= 3921-7 | pmid=9403616 | doi=10.1161/01.cir.96.11.3921 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=9403616 }} </ref> | ||
=References= | =References= | ||
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Latest revision as of 03:53, 9 August 2020
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Paroxysmal AV block Microchapters |
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Paroxysmal AV block historical perspective On the Web |
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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
One of the first reported cases of paroxysmal AV block was secondary to mitral valvulitis, indicating an intrinsic conduction defect. A similar block was later seen in the Bundle of His, wherein during a hypothesized zone of opportunity, a spontaneous depolarization of conducting fibres was seen. Idiopathic paroxysmal AV block may be diagnosed by a positive response to adenosine triphosphate.
Famous Cases
- In 1931, Adolph Sachs et al reported one of the first cases on paroxysmal AV block. The patient had presented with multiple spells of palpitations, hot flashes, dizziness, ringing in the ears, weakness and diaphoresis accompanied by convulsions. During an acute episode, he noticed an irregular ventricular rhythm, irregular complexes and given a time interval of 30 seconds, the ventricle would beat once in the first 15 second window and 4-5 times in the succeeding window. It was noticed that the duration of the block progressively increased until it was present all the time. Mitral valvulitis was put down as the cause of the attack and the fact that a response to atropine does not rule out an intrinsic conduction defect was emphasized. [1]
- In 1972, Philippe Coumel et al hypothesized that the cause of bradycardia/pause dependent AV block was the spontaneous depolarization of specialized conducting fibers in the late stages of diastole. It was during this ‘zone of opportunity’ that they noticed this ‘AV dissociation’. In this case, they found that the block occurred to be proximal to the division of the His bundle. [2]
- In 1997. Brignole et al first described EI AVB in a group of 15 syncope patients with an initial negative work up. They fortuitously stumbled upon ECG findings indicating a paroxysmal AV block and reconfirmed this by performing an adenosine triphosphate test in each patient. [3]
References
- ↑ Sachs, Adolph; Traynor, Raymond L. (1933). "Paroxysmal complete auriculo-ventricular heart-block". American Heart Journal. 9 (2): 267–271. doi:10.1016/S0002-8703(33)90722-X. ISSN 0002-8703.
- ↑ Coumel P, Fabiato A, Waynberger M, Motte G, Slama R, Bouvrain Y (1971). "Bradycardia-dependent atrio-ventricular block. Report of two cases of A-V block elicited by premature beats". J Electrocardiol. 4 (2): 168–77. doi:10.1016/s0022-0736(71)80010-9. PMID 5113605.
- ↑ Brignole M, Gaggioli G, Menozzi C, Gianfranchi L, Bartoletti A, Bottoni N; et al. (1997). "Adenosine-induced atrioventricular block in patients with unexplained syncope: the diagnostic value of ATP testing". Circulation. 96 (11): 3921–7. doi:10.1161/01.cir.96.11.3921. PMID 9403616.