OBSERVATIONAL STUDY
Add like
Add dislike
Add to saved papers

"First-degree AV block-a benign entity?" Insertable cardiac monitor in patients with 1st-degree AV block reveals presence or progression to higher grade block or bradycardia requiring pacemaker implant.

BACKGROUND: First-degree AV block has in the past generally been considered a benign condition. A few recent studies have shown that 1st-degree AV block is associated with an increased risk for heart failure, pacemaker (IPG) implantation, and death. We investigated the outcomes of patients who received an insertable cardiac monitor (ICM) (Medtronic Reveal XT®) within the scope of the INSIGHT XT study and had 1st-degree AV block at baseline.

METHODS: The observational, international, multi-center INSIGHT (R)XT study prospectively enrolled 1003 patients implanted with an ICM for arrhythmia diagnosis, irrespective of the clinical indication. This analysis includes 37 patients who had documented 1st-degree AV block at enrolment. Patients with known concurrent higher grade block at enrolment were excluded.

RESULTS: The indications for rhythm monitoring and ICM implantation were syncope/pre-syncope in 54.1%, cryptogenic stroke in 18.9%, AF with rhythm control intervention in 21.6%, and unexplained palpitations in 5.4%. Mean age was 68 ± 14 years, 75.7% were male, and concurrent bundle branch block was present in 8.1%. The median follow-up time was 12.2 months (IQR3.9-15.9). Fifteen patients (40.5%) received an IPG during the follow-up, and in 93.3% of the cases, the implant was needed to treat a now detected more severe bradycardia or progression of the conduction disease.

CONCLUSIONS: ICM either revealed progression of 1st-degree AV block to a higher grade block (53%) or detected an already existing more severe bradycardia warranting an IPG in 40.5% patients. This finding supports the conclusion that 1st-degree AV block might be a risk marker for more severe intermittent conduction disease and is not benign in all patients. Further studies may reveal patient subgroups which are at risk for demonstrating or developing higher grade AV block and may warrant a future IPG implantation.

Full text links

For the best experience, use the Read mobile app

Group 7SearchHeart failure treatmentPapersTopicsCollectionsEffects of Sodium-Glucose Cotransporter 2 Inhibitors for the Treatment of Patients With Heart Failure Importance: Only 1 class of glucose-lowering agents-sodium-glucose cotransporter 2 (SGLT2) inhibitors-has been reported to decrease the risk of cardiovascular events primarily by reducingSeptember 1, 2017: JAMA CardiologyAssociations of albuminuria in patients with chronic heart failure: findings in the ALiskiren Observation of heart Failure Treatment study.CONCLUSIONS: Increased UACR is common in patients with heart failure, including non-diabetics. Urinary albumin creatininineJul, 2011: European Journal of Heart FailureRandomized Controlled TrialEffects of Liraglutide on Clinical Stability Among Patients With Advanced Heart Failure and Reduced Ejection Fraction: A Randomized Clinical Trial.Review

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app

Read by QxMD is copyright © 2021 QxMD Software Inc. All rights reserved. By using this service, you agree to our terms of use and privacy policy.

Get seemless 1-tap access through your institution/university

For the best experience, use the Read mobile app