Exercise induced complete atrioventricular block: Utility of exercise stress test

Yandrapalli, Srikanth; Harikrishnan, Prakash; Ojo, Amole; Vuddanda, Venkat; Jain, Diwakar

doi:10.1016/j.jelectrocard.2017.09.001

Cited by 14 publications

(7 citation statements)

References 4 publications

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“…CAVB during exercise is an infrequent finding [8,[10][11][12][13]. A contemporary systematic review of the literature proposes several…”

Section: Discussionmentioning

confidence: 99%

“…One limitation of the present report relates to the absence of an electrophysiological study (EPS). As previously described, most cases of reported exercise induced CAVB are infranodal [10,11,17], though there are also reports describing a supranodal block [8], suggesting the utility of EPS to ascertain the specific site in question [8,10,13]. One possible explanation for exercise induced CAVB, as previously described [10,11,13], derives from the differences in the conduction properties and refractory periods between the AV node (with increased conduction and decreased refractory period associated with exercise) and the His-Purkinje system (not under autonomic control, and as such whose refractory period is not substantially altered by exercise).…”

Section: This Article Is Distributed Under the Terms Of The Creative Commonsmentioning

confidence: 97%

“…As previously described, most cases of reported exercise induced CAVB are infranodal [10,11,17], though there are also reports describing a supranodal block [8], suggesting the utility of EPS to ascertain the specific site in question [8,10,13]. One possible explanation for exercise induced CAVB, as previously described [10,11,13], derives from the differences in the conduction properties and refractory periods between the AV node (with increased conduction and decreased refractory period associated with exercise) and the His-Purkinje system (not under autonomic control, and as such whose refractory period is not substantially altered by exercise). Contrary to the physiologic response elicited in a normal conduction system, in the presence of conduction tissue disease (such as the case presented, given the baseline ECG characteristics) the diseased His-Purkinje system could thus be unable to conduct the impulses form the rapidly conducting AV node, and as such lead to a CAVB [10,11,13].…”

Section: This Article Is Distributed Under the Terms Of The Creative Commonsmentioning

confidence: 97%

“…potential mechanisms for this phenomenon [10]. Although intrinsic conduction tissue disease seems of paramount importance [8,10], an ischemic contribution can also be present and should be excluded [10,11,13]. Indeed, an ischemic defect affecting the atrioventricular (AV) node has been described as a possible cause of exercise-induced CAVB [10,13,14].…”

Section: Case Reportmentioning

confidence: 99%

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Complete atrioventricular block during exercise: New insights from an old test

Vilela

Torres²,

Gonçalves³

et al. 2019

Monaldi Arch Chest Dis

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Exercise stress testing can have a central role in the assessment of cardiovascular disease. Contemporary data, however, has highlighted the added value of imaging modalities over the exercise electrocardiogram in the investigation of coronary artery disease. Given the physiological changes associated with exercise and the possibility to address other parameters such as rhythm changes and the chronotropic response, exercise stress testing with continuous electrocardiographic monitoring can still have an important place in contemporary clinical practice. We report the case of a complete atrioventricular block associated with exercise and discuss the current role of exercise stress testing with continuous electrocardiographic monitoring in this entity.

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“…CAVB during exercise is an infrequent finding [8,[10][11][12][13]. A contemporary systematic review of the literature proposes several…”

Section: Discussionmentioning

confidence: 99%

Section: This Article Is Distributed Under the Terms Of The Creative Commonsmentioning

confidence: 97%

Section: This Article Is Distributed Under the Terms Of The Creative Commonsmentioning

confidence: 97%

Section: Case Reportmentioning

confidence: 99%

See 2 more Smart Citations

Complete atrioventricular block during exercise: New insights from an old test

Vilela

Torres²,

Gonçalves³

et al. 2019

Monaldi Arch Chest Dis

View full text Add to dashboard Cite

show abstract

“…When progressive AV block occurs during exercise, conduction disturbance within the His-Purkinje system is suspected and is associated with a poor prognosis. 20 With the exception of infiltrative or inflammatory causes, the criteria for pacemaker implantation are similar to those for CCAVB.…”

Section: Recommendation-specific Supportive Textmentioning

confidence: 99%

2021 PACES Expert Consensus Statement on the Indications and Management of Cardiovascular Implantable Electronic Devices in Pediatric Patients: Executive Summary

et al. 2021

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