Management of Heart Block; Pacing or Drugs! - USMLE Forums
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Old 06-07-2011
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Heart Management of Heart Block; Pacing or Drugs!

We all know that Mobitz II and Heart block third degree; both groups they get a pacemaker (EVEN if asympotmatic)

The question here: is the next step ATROPINE or PACING for asymptomatic 3rd or Mobitz II heart block?!?
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Old 06-07-2011
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Default High risk of progression to higer degree heart block!

Treatment is required for a Mobitz type II AV block. A temporary or permanent pacemaker is inserted. Drug therapy is either ineffective or unreliable. (http://www.mdguidelines.com/atrioven...-second-degree)

This is tricky. Because of the fact mentioned in above reference, the answer should be pacing. However, in real world atropine is used in symptomatic patient to save some time while preparing for pacing! I notice your patient is asymptomatic. So I would go with pacing.
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Old 06-07-2011
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Default

thanks as usual!
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Cardiology-, Emergency-Medicine, Internal-Medicine-

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