Overview
Complete atrioventricular (AV) block is a cardiac conduction disorder characterized by the absence of impulse transmission from the atria to the ventricles, resulting in bradycardia and potential hemodynamic instability 1.Diagnosis
Electrocardiogram (ECG) showing absent P waves with regular ventricular response 1.
Assessment of heart rate and rhythm variability 1.
Holter monitoring for prolonged evaluation in stable patients 1.Management
First-line: Temporary pacing may be considered pre-labor but is not routinely required during labor and delivery if no permanent pacemaker is in place 1.
Adjunctive: Permanent pacemaker implantation recommended for definitive management in non-pregnant patients 1.Special Populations
Pregnancy: Women with complete AV block without a permanent pacemaker may not require temporary pacing during labor and delivery 1.Key Recommendations
Temporary pacing is not routinely necessary during labor and delivery for women with complete AV block without a permanent pacemaker (Evidence: Weak) 1.
Consider temporary pacing lead insertion pre-labor but reassess need intraoperatively 1.
Permanent pacemaker implantation is advised for long-term management in non-pregnant patients with complete AV block (Evidence: Expert opinion) 1.References
1 Hidaka N, Chiba Y, Kurita T, Satoh S, Nakano H. Is intrapartum temporary pacing required for women with complete atrioventricular block? An analysis of seven cases. BJOG : an international journal of obstetrics and gynaecology 2006. link