Journal Article

High-degree atrioventricular block during anti-arrhythmic drug treatment: use of a pacemaker with a bradycardia-detection algorithm to study the time course after drug withdrawal

Göran Kennebäck, Fariborz Tabrizi, Peter Lindell and Rolf Nordlander

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 3, pages 186-191
Published in print March 2007 | ISSN: 1099-5129
Published online January 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eul185
High-degree atrioventricular block during anti-arrhythmic drug treatment: use of a pacemaker with a bradycardia-detection algorithm to study the time course after drug withdrawal

Show Summary Details

Preview

Aim This study examines the recurrence of high-degree atrioventricular block (AVB) during a follow-up period of 2 years in patients with restored AV node function after antiarrhythmic drug withdrawal at implantation of a pacemaker.

Methods Nine men and eight women (77 ± 7 years) taking antiarrhythmic drugs (beta-receptor blockers in 15) and presenting with high-degree AVB were followed for 2 years after being taken off drugs upon receiving a permanent pacemaker with special bradycardia detection software.

Results At inclusion, surface ECG identified two subsets of patients: a QRS duration < 120 ms (n = 5) and those with a QRS duration ≥120 ms (n = 12). During the 2-year follow-up, progression to high-degree AVB occurred in these groups: 1/5 (20%) and 9/12 (75%) P < 0.05. Six patients had to be restarted on drugs, mostly beta-receptor blockers, due to atrial tachyarrhythmias: 3/5 and 3/12. In total, 16 patients (94%) either developed high-degree AVB needing pacing or atrial tachyarrhythmias requiring drug treatment.

Conclusion Patients on beta-receptor blocking drugs and QRS width ≥120 ms developing high-degree AVB should be recommended a pacemaker without further investigation or observation.

Keywords: Atrioventricular block; Drugs; Pacemaker; Pacemaker algorithm

Journal Article.  3357 words.  Illustrated.

Subjects: Cardiovascular Medicine

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.