Spontaneous resolution may occur but warrants evaluation of AV nodal and infranodal conduction (eg, electrophysiologic study, exercise testing, 24-hour ECG). A block caused by anterior myocardial infarction usually reflects extensive myocardial necrosis involving the His-Purkinje system and requires immediate transvenous pacemaker insertion with interim external pacing as necessary. A block caused by acute inferior myocardial infarction usually reflects atrioventricular nodal dysfunction and may respond to atropine or resolve spontaneously over several days. read more, stopping the drug may be effective, although temporary pacing may be needed. If necessary, direct antiarrhythmic therapy, including antiarrhythmic. If the block is caused by antiarrhythmic drugs Medications for Arrhythmias The need for treatment of arrhythmias depends on the symptoms and the seriousness of the arrhythmia. If necessary, direct antiarrhythmic therapy, including antiarrhythmic. Overview When the SA node fails to create an electrical signal for the heart beat, the atrioventricular (AV) node provides this pacemaking. Most patients require a pacemaker Cardiac Pacemakers The need for treatment of arrhythmias depends on the symptoms and the seriousness of the arrhythmia. read more, which may also benefit asymptomatic patients with Mobitz type I second-degree AV block at infranodal sites detected by electrophysiologic studies done for other reasons. Treatment is pacemaker insertion Cardiac Pacemakers The need for treatment of arrhythmias depends on the symptoms and the seriousness of the arrhythmia. read more and transient or reversible causes have been excluded. Treatment is therefore unnecessary unless the block causes symptomatic bradycardia Bradyarrhythmias The normal heart beats in a regular, coordinated way because electrical impulses generated and spread by myocytes with unique electrical properties trigger a sequence of organized myocardial. If the block becomes complete, a reliable junctional escape rhythm typically develops. The block occurs at the AV node in about 75% of patients with a narrow QRS complex and at infranodal sites (His bundle, bundle branches, or fascicles) in the rest. If the rate is faster than 100, we call this junctional tachycardia. Mobitz type I second-degree AV block may be physiologic in younger and more athletic patients. Junctional escape rhythm is defined as junctional escape rhythm when there are three or more consecutive junctional escape beats.
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