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Tytuł:
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Evaluating and managing bradycardia.
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Autorzy:
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Sidhu S; Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Carnegie 572, Baltimore 21787, MD, United States.
Marine JE; Division of Cardiology, Department of Medicine, Johns Hopkins University School of Medicine, 600 North Wolfe Street, Carnegie 572, Baltimore 21787, MD, United States. Electronic address: .
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Źródło:
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Trends in cardiovascular medicine [Trends Cardiovasc Med] 2020 Jul; Vol. 30 (5), pp. 265-272. Date of Electronic Publication: 2019 Jul 09.
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Typ publikacji:
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Journal Article; Review
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Język:
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English
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Imprint Name(s):
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Publication: New York Ny : Elsevier Science Publishing
Original Publication: New York : Elsevier Science Pub. Co.,
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MeSH Terms:
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Cardiac Pacing, Artificial*/adverse effects
Heart Rate*
Pacemaker, Artificial*
Atrioventricular Block/*therapy
Bradycardia/*therapy
Heart Conduction System/*physiopathology
Sick Sinus Syndrome/*therapy
Action Potentials ; Atrioventricular Block/diagnosis ; Atrioventricular Block/physiopathology ; Bradycardia/diagnosis ; Bradycardia/physiopathology ; Clinical Decision-Making ; Humans ; Patient Selection ; Sick Sinus Syndrome/diagnosis ; Sick Sinus Syndrome/physiopathology ; Treatment Outcome
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Entry Date(s):
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Date Created: 20190718 Date Completed: 20201020 Latest Revision: 20201020
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Update Code:
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20240105
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DOI:
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10.1016/j.tcm.2019.07.001
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PMID:
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31311698
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Bradycardia is a commonly observed arrhythmia and a frequent occasion for cardiac consultation. Defined as a heart rate of less than 50-60 bpm, bradycardia can be observed as a normal phenomenon in young athletic individuals, and in patients as part of normal aging or disease (Table 1). Pathology that produces bradycardia may occur within the sinus node, atrioventricular (AV) nodal tissue, and the specialized His-Purkinje conduction system. Given the overlap of heart rate ranges with non-pathologic changes, assessment of symptoms is a critical component in the evaluation and management of bradycardia. Treatment should rarely be prescribed solely on the basis of a heart rate lower than an arbitrary cutoff or a pause above certain duration. In the 2018 ACC/AHA/HRS Guideline on the Evaluation and Management of Patients with Bradycardia and Cardiac Conduction Delay (referred to hereafter as the 2018 Bradycardia Guideline), there was a significant shift in emphasis from prior guidelines that emphasized device-based implantation recommendations to a focus on evaluation and management of disease states [1,2]. In this review, we will highlight the changes in the new guideline as well as describe the key elements in evaluation and management of patients presenting with bradycardia.
(Copyright © 2019 The Author(s). Published by Elsevier Inc. All rights reserved.)
Comment in: Trends Cardiovasc Med. 2020 Jul;30(5):273-274. (PMID: 31383510)
