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8/10/2019 Bradyarrhythmias/CCM Board review
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Vagus nerve
Slows pacemaker cells
Slows sinus node (R>L)
Slows AV node (L>R)
Minimal effect on HPS
Sympathetic nerves
Accelerates pacemaker cellsFacilitates AVN conduction
Minimal effect on HPS
afferent vagal n.
efferent vagal n.
sympathetic n.
catecholamines
DorsalNucleusl
CarotidSinus
Sympathetic
Trunk
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First Degree AV Block
Second Degree AV Block
Type 1
Second Degree AV Block
Type 2
Third Degree AV Block
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@)'1 /E 7J !./-NFirst Degree AV Block
Delay in atrium or AV node leadingto prolonged PR interval
Second Degree (type 1) AV BlockDelay and block in AV node leading to
progressive increase of PR interval
Second Degree (type 2) AV Block
Intermittent block usually in the His-Purkinje
system leading to blocked P wave
Third Degree AV Block
Complete block in AV node or His-Purkinje
systemInfra-nodal conduction diseaseassociated with poor prognosis
and may warrant pacemaker
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ventricular pacing at 80 ppm
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18 y/o male with ICD for long QT stepsinto a pool holding on to metal rail
Atrial lead
Vent lead
Noise ICD Shock Steps out of pool
Recommended