Key result
Prophylactic temporary pacing is not routinely justified for perioperative bifascicular block with prolonged PR.
Why the study?
The diagnosis of trifascicular block cannot be made from a single ECG showing bifascicular block with prolonged PR, and the risk of AV block during anesthesia and surgery is uncertain.
Does temporary pacemaker insertion prevent intraoperative AV block in asymptomatic patients with bifascicular block and prolonged PR?
Case Report (n=2)
Does temporary pacemaker insertion prevent intraoperative AV block in asymptomatic patients with bifascicular block and prolonged PR?
Trifascicular block cannot be diagnosed from a single ECG showing bifascicular block with prolonged PR, and prophylactic temporary pacing is generally not justified for non-cardiac surgery.
May not justify routine prophylactic pacing in asymptomatic bifascicular block with prolonged PR; hypothesis-generating pending higher-level evidence.
Trifascicular block cannot be diagnosed from a single ECG showing bifascicular block with prolonged PR. The risk of AV block during anaesthesia and surgery is low. If AV block occurs, it is likely to be vagally induced (Wenckebach),rather than Mobitz II. The risk of a temporary pacemaker is not usually justified.
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Rob Scott Millar (2017) conducted a case report in Bifascicular block with prolonged PR interval (n=2). Prophylactic temporary pacemaker insertion vs. Standard monitoring without temporary pacing was evaluated on Development of high-grade AV block during surgery. The risk of developing high-grade AV block during surgery in patients with bifascicular block and prolonged PR is low, and routine prophylactic temporary pacing is not usually justified.
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