open access

Vol 9, No 2 (2014)
Guidelines and Clinical Practice — a Discussion Forum for Cardiologists
Published online: 2014-06-27
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Second-degree atrioventricular block — a challenge in establishing indications for pacemaker therapy

Dawid Bąkowski, Justyna Niedziela, Beata Wożakowska-Kapłon
Folia Cardiologica 2014;9(2):186-192.

open access

Vol 9, No 2 (2014)
Guidelines and Clinical Practice — a Discussion Forum for Cardiologists
Published online: 2014-06-27

Abstract

Acquired second-degree atrioventricular (AV) block requires pacemaker therapy if causes symptoms or the conduction disturbances occur at intra- or infra-His levels. The determination of block anatomical location based merely on standard electrocardiography (ECG) may be difficult and not conclusive. Then it is necessary to extend the diagnostics including functional tests and electrophysiological study (EPS). We present two patients with the history of syncope and diagnosed second-degree AV block. In the first case, the patient avoided pacemaker therapy due to precise analysis of ECG and other tests including EPS, which led to diagnosis of proximal second-degree AV block type 1. In the second case, pacemaker therapy was implemented in patient with vasovagal syndrome in spite of reflex mechanism of AV block.

Abstract

Acquired second-degree atrioventricular (AV) block requires pacemaker therapy if causes symptoms or the conduction disturbances occur at intra- or infra-His levels. The determination of block anatomical location based merely on standard electrocardiography (ECG) may be difficult and not conclusive. Then it is necessary to extend the diagnostics including functional tests and electrophysiological study (EPS). We present two patients with the history of syncope and diagnosed second-degree AV block. In the first case, the patient avoided pacemaker therapy due to precise analysis of ECG and other tests including EPS, which led to diagnosis of proximal second-degree AV block type 1. In the second case, pacemaker therapy was implemented in patient with vasovagal syndrome in spite of reflex mechanism of AV block.

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Keywords

second-degree AV block, syncope, pacemaker therapy

About this article
Title

Second-degree atrioventricular block — a challenge in establishing indications for pacemaker therapy

Journal

Folia Cardiologica

Issue

Vol 9, No 2 (2014)

Pages

186-192

Published online

2014-06-27

Bibliographic record

Folia Cardiologica 2014;9(2):186-192.

Keywords

second-degree AV block
syncope
pacemaker therapy

Authors

Dawid Bąkowski
Justyna Niedziela
Beata Wożakowska-Kapłon

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