Vagally mediated atrioventricular block: current pathophysiology and diagnosis

È in pubblicazione sulla rivista inglese "Heart" l'articolo "Vagally mediated atrioventricular block: current pathophysiology and diagnosis" di Alboni P, Holtz A, Brignole M. Lo studio è frutto della collaborazione fra la Sezione di Cardiologia dell'Ospedale Privato Accreditato Quisisana (Ferrara) e il Dipartimento di Cardiologia degli Ospedali del Tigullio (Lavagna). 


Vagally mediated atrioventricular (AV) block is defined as a paroxysmal AV block, localized within the AV node, associated to slowing of the sinus rate. All types of second degree AV block, including pseudo-Mobitz II block, and complete AV block may be present. Most of the patients have normal AV conduction. Differential diagnosis with intrinsic AV block is based on the behavior of sinus rate. Vagally mediated AV block is benign; it can be recorded as a asymptomatic or symptomatic event (syncope/presyncope). Syncope due to this form of AV block should be diagnosed and managed as neurally mediated syncope. When this block is fortuitously recorded in asymptomatic patients, pacemaker implantation is not indicated.