HRS Board Review 2025 New Courses (Reviewers Copy)-Workshop 1_Electrocardio_Miller_2025

Workshop 1_Electrocardio_Miller_2025_case 1 answer

Video Transcription

Video Summary

The patient needs a dual chamber pacemaker due to paroxysmal AV block, not vagal stimulation, as indicated by a non-conducted PAC. While sometimes it appears benign, this condition poses a risk of sudden death from unrecoverable block. Insertion of a pacemaker is critical since an EP study might falsely reassure, showing normal conduction at the time. Observing the subtle acceleration in PP intervals confirms the condition is not vagal. The situation is dangerous despite the patient's recovery in this case, highlighting the necessity for pacing intervention.

Keywords

dual chamber pacemaker

paroxysmal AV block

non-conducted PAC

sudden death risk

pacing intervention