Key result
Among 42 patients with complete antegrade atrioventricular block and implanted cardiac rhythm management devices, the prevalence of intact retrograde ventriculoatrial conduction was 11.9%.
Why the study?
The authors sought to describe the prevalence and clinical significance of intact ventriculoatrial conduction accompanied by complete antegrade atrioventricular block in patients with implanted cardiac rhythm management devices.
Cross-Sectional (n=42)
No
Intact retrograde VA conduction is present in approximately 12% of patients with complete AV block, highlighting the need to test for it to prevent pacemaker-mediated tachycardias.
May warrant retrograde VA testing to avoid pacemaker-mediated tachycardia; leaves open prevalence in larger prospective cohorts.
Intact retrograde ventriculoatrial (VA) conduction in the presence of complete atrioventricular (AV) heart block has been well-documented in the past. We sought to describe the prevalence and clinical significance of intact VA conduction accompanied by complete antegrade AV block in patients with implanted cardiac rhythm management (CRM) devices. During routine follow-up of CRM devices in our device clinic, 42 patients were found to be in a state of complete heart block. All patients presented in sinus rhythm. The patients' underlying rhythms were tested with the inhibition of pacing and documented AV dissociation. Subsequently, retrograde VA conduction was tested with ventricular pacing. In the 42 patients with complete heart block as the underlying rhythm, five patients demonstrated retrograde VA conduction. In conclusion, the prevalence of intact of VA conduction was 11.9% in our study. The implications of this phenomenon can have noteworthy clinical significance. The occurrence of pacemaker-mediated tachycardia and repetitive nonreentrant VA synchrony are discussed herein. All patients, even those with a device indication of complete heart block, should be tested for retrograde conduction at implantation and during routine follow-up.
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Dhir et al. (2019) conducted a cross-sectional in Complete atrioventricular block (n=42). Complete atrioventricular block was evaluated on Prevalence of intact retrograde ventriculoatrial (VA) conduction. Among 42 patients with complete antegrade atrioventricular block and implanted cardiac rhythm management devices, the prevalence of intact retrograde ventriculoatrial conduction was 11.9%.
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