bradyarrhythmias/ccm board review

8/10/2019 Bradyarrhythmias/CCM Board review

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Vagus nerve

Slows pacemaker cells

Slows sinus node (R>L)

Slows AV node (L>R)

Minimal effect on HPS

Sympathetic nerves

Accelerates pacemaker cellsFacilitates AVN conduction

Minimal effect on HPS

afferent vagal n.

efferent vagal n.

sympathetic n.

catecholamines

DorsalNucleusl

CarotidSinus

Sympathetic

Trunk


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First Degree AV Block

Second Degree AV Block

Type 1

Second Degree AV Block

Type 2

Third Degree AV Block


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@)'1 /E 7J !./-NFirst Degree AV Block

Delay in atrium or AV node leadingto prolonged PR interval

Second Degree (type 1) AV BlockDelay and block in AV node leading to

progressive increase of PR interval

Second Degree (type 2) AV Block

Intermittent block usually in the His-Purkinje

system leading to blocked P wave

Third Degree AV Block

Complete block in AV node or His-Purkinje

systemInfra-nodal conduction diseaseassociated with poor prognosis

and may warrant pacemaker


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Figure 1


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ventricular pacing at 80 ppm


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18 y/o male with ICD for long QT stepsinto a pool holding on to metal rail

Atrial lead

Vent lead

Noise ICD Shock Steps out of pool

bradyarrhythmias/ccm board review

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