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Second degree AV block echocardiography

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Sara Zand, M.D.[2]

Overview

Echocardiography is useful for finding the underlying structural heart disease including left ventricular systolic dysfunction in patients with atrioventricular block, especially in the presence of LBBB pattern on resting ECG.



Recommendations for Echocardiography in Bradycardia or Conduction disorder
Echocardiography (Class I, Level of Evidence B):

Echocardiography is recommended in patients with newly identified LBBB, second-degree Mobitz type II atrioventricular block, high-grade atrioventricular block, or third-degree atrioventricular block with or without apparent structural heart disease or coronary artery disease

Echocardiography ( Class IIa, Level of Evidence B) :

Echocardiography is recommended in suspicion of structural heart disease in patients presented with bradycardia or conduction disorders other than LBBB, second-degreeMobitz type II atrioventricular block, high-grade atrioventricular block, or third-degree atrioventricular block

Abbreviations: LBBB: Left bundle branch block

The above table adopted from 2018 AHA/ACC/HRS Guideline[2]

References

  1. Douglas PS, Garcia MJ, Haines DE, Lai WW, Manning WJ, Patel AR, Picard MH, Polk DM, Ragosta M, Parker Ward R, Weiner RB (March 2011). “ACCF/ASE/AHA/ASNC/HFSA/HRS/SCAI/SCCM/SCCT/SCMR 2011 Appropriate Use Criteria for Echocardiography. A Report of the American College of Cardiology Foundation Appropriate Use Criteria Task Force, American Society of Echocardiography, American Heart Association, American Society of Nuclear Cardiology, Heart Failure Society of America, Heart Rhythm Society, Society for Cardiovascular Angiography and Interventions, Society of Critical Care Medicine, Society of Cardiovascular Computed Tomography, Society for Cardiovascular Magnetic Resonance American College of Chest Physicians”. J Am Soc Echocardiogr. 24 (3): 229–67. doi:10.1016/j.echo.2010.12.008. PMID 21338862.
  2. Kusumoto, Fred M.; Schoenfeld, Mark H.; Barrett, Coletta; Edgerton, James R.; Ellenbogen, Kenneth A.; Gold, Michael R.; Goldschlager, Nora F.; Hamilton, Robert M.; Joglar, José A.; Kim, Robert J.; Lee, Richard; Marine, Joseph E.; McLeod, Christopher J.; Oken, Keith R.; Patton, Kristen K.; Pellegrini, Cara N.; Selzman, Kimberly A.; Thompson, Annemarie; Varosy, Paul D. (2019). “2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients With Bradycardia and Cardiac Conduction Delay: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Rhythm Society”. Circulation. 140 (8). doi:10.1161/CIR.0000000000000628. ISSN 0009-7322.


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