Paroxysmal atrioventricular block: clinical experience with 20 patients

Ronit SHOHAT-ZABARSKI; Zaza IAKOBISHVILI; Jairo KUSNIEC; Alexander MAZUR; Boris STRASBERG

doi:10.1016/j.ijcard.2003.10.023

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Paroxysmal atrioventricular block: clinical experience with 20 patients

Journal article

Peer reviewed

Paroxysmal atrioventricular block: clinical experience with 20 patients

Ronit SHOHAT-ZABARSKI, Zaza IAKOBISHVILI, Jairo KUSNIEC, Alexander MAZUR and Boris STRASBERG

International journal of cardiology, Vol.97(3), pp.399-405

2004

DOI: 10.1016/j.ijcard.2003.10.023

PMID: 15561325

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Abstract

Background: Paroxysmal atrioventricular (AV) block is an ill-defined entity, previously described in sporadic cases in association with vasovagal reaction, coronary angiography and distal conduction disease. Methods: We describe 20 patients (10 women) aged 26 to 80 years with symptomatic paroxysmal AV block. Results: Eight patients had ischemic heart disease-three with dilated cardiomyopathy, and two with co-existing carotid sinus hypersensitivity. Eight were taking chronic AV blockers. In five patients, the paroxysmal AV block occurred during a vagal reaction, in one during migranotic headaches, in one following aortic valve replacement and in one while recovering from acute myocardial infarction. The events lasted between 2.2 and 36 s. In 10 patients, the QRS configuration on the electrocardiogram was wide. Immediate treatment consisted of intravenous atropine and fluid supplements in two patients, discontinuation of the AV blocking agents in four, and the insertion of a temporary pacemaker in eight. Seventeen patients required a permanent pacemaker. Conclusions: Paroxysmal AV block is an underestimated clinical entity related to vagal reaction, AV blocking drugs and distal conduction disease. Most of our patients eventually required implantation of a permanent pacemaker.

Heart

Neurology

Cardiology. Vascular system

Disorders of higher nervous function. Focal brain diseases. Central vestibular syndrome and deafness. Brain stem syndromes

Cardiac dysrhythmias

Headache. Facial pains. Syncopes. Epilepsia. Intracranial hypertension. Brain oedema. Cerebral palsy

Biological and medical sciences

Medical sciences

Nervous system (semeiology, syndromes)

Details

Title: Subtitle: Paroxysmal atrioventricular block: clinical experience with 20 patients
Creators: Ronit SHOHAT-ZABARSKI - Department of Cardiology, Petah Tiqva Faculty of Medicine, Rabin Medical Center Beilinson Campus, Tel Aviv University, Tel Aviv, Israel
Zaza IAKOBISHVILI - Department of Cardiology, Petah Tiqva Faculty of Medicine, Rabin Medical Center Beilinson Campus, Tel Aviv University, Tel Aviv, Israel
Jairo KUSNIEC - Department of Cardiology, Petah Tiqva Faculty of Medicine, Rabin Medical Center Beilinson Campus, Tel Aviv University, Tel Aviv, Israel
Alexander MAZUR - Department of Cardiology, Petah Tiqva Faculty of Medicine, Rabin Medical Center Beilinson Campus, Tel Aviv University, Tel Aviv, Israel
Boris STRASBERG - Department of Cardiology, Petah Tiqva Faculty of Medicine, Rabin Medical Center Beilinson Campus, Tel Aviv University, Tel Aviv, Israel
Resource Type: Journal article
Publication Details: International journal of cardiology, Vol.97(3), pp.399-405
DOI: 10.1016/j.ijcard.2003.10.023
PMID: 15561325
NLM abbreviation: Int J Cardiol
ISSN: 0167-5273
eISSN: 1874-1754
Publisher: Elsevier Science
Language: English
Date published: 2004
Academic Unit: Cardiovascular Medicine; Internal Medicine
Record Identifier: 9984094560302771

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