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Bradyarrhythmia
Michael D. Puchalski, MD; Thomas A. Miller, DO
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KEY FACTS

  • Terminology

    • Imaging

      • Pathology

        • Clinical Issues

          TERMINOLOGY

          • Definitions

            • Abnormally slow heart rate < 100 beats per minute (BPM)
            • Benign transient bradycardia
              • Slowing of fetal heart rate followed by rapid and progressive recovery
              • Due to vagal stimulation
            • Sinus or low atrial bradycardia
              • Typical rates 90-130 BPM
              • Atrioventricular (AV) conduction intact
            • 1st-degree AV block
              • Long PR interval but maintained 1:1 AV conduction
            • 2nd-degree AV block
              • Long PR interval with intermittent AV conduction and AV block
            • Complete heart block (CHB)
              • Atrial rate normal
              • Slow independent ventricular rate (40-90 BPM)
                • Due to failed conduction from atrium to ventricle
            • Blocked premature atrial contractions (PAC)
              • Early atrial beat not followed by ventricular beat

          IMAGING

          • General Features

            • Echocardiographic Findings

              • Imaging Recommendations

                DIFFERENTIAL DIAGNOSIS

                  PATHOLOGY

                  • General Features

                    CLINICAL ISSUES

                    • Presentation

                      • Demographics

                        • Natural History & Prognosis

                          • Treatment

                            DIAGNOSTIC CHECKLIST

                            • Consider

                              • Image Interpretation Pearls

                                Selected References

                                1. Hunter LE et al: Atrioventricular block during fetal life. J Saudi Heart Assoc. 27(3):164-78, 2015
                                2. Mitchell JL et al: Fetal heart rate predictors of long QT syndrome. Circulation. 126(23):2688-95, 2012
                                3. Friedman DM et al: Utility of cardiac monitoring in fetuses at risk for congenital heart block: the PR Interval and Dexamethasone Evaluation (PRIDE) prospective study. Circulation. 117(4):485-93, 2008
                                4. Jaeggi ET et al: Diagnosis and management of fetal bradyarrhythmias. Pacing Clin Electrophysiol. 31 Suppl 1:S50-3, 2008
                                5. Lopes LM et al: Perinatal outcome of fetal atrioventricular block: one-hundred-sixteen cases from a single institution. Circulation. 2008 Sep 16;118(12):1268-75. Epub 2008 Sep 2. Erratum in: Circulation. 118(16): e671, 2008
                                Related Anatomy
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                                Related Differential Diagnoses
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                                References
                                Tables

                                Tables

                                KEY FACTS

                                • Terminology

                                  • Imaging

                                    • Pathology

                                      • Clinical Issues

                                        TERMINOLOGY

                                        • Definitions

                                          • Abnormally slow heart rate < 100 beats per minute (BPM)
                                          • Benign transient bradycardia
                                            • Slowing of fetal heart rate followed by rapid and progressive recovery
                                            • Due to vagal stimulation
                                          • Sinus or low atrial bradycardia
                                            • Typical rates 90-130 BPM
                                            • Atrioventricular (AV) conduction intact
                                          • 1st-degree AV block
                                            • Long PR interval but maintained 1:1 AV conduction
                                          • 2nd-degree AV block
                                            • Long PR interval with intermittent AV conduction and AV block
                                          • Complete heart block (CHB)
                                            • Atrial rate normal
                                            • Slow independent ventricular rate (40-90 BPM)
                                              • Due to failed conduction from atrium to ventricle
                                          • Blocked premature atrial contractions (PAC)
                                            • Early atrial beat not followed by ventricular beat

                                        IMAGING

                                        • General Features

                                          • Echocardiographic Findings

                                            • Imaging Recommendations

                                              DIFFERENTIAL DIAGNOSIS

                                                PATHOLOGY

                                                • General Features

                                                  CLINICAL ISSUES

                                                  • Presentation

                                                    • Demographics

                                                      • Natural History & Prognosis

                                                        • Treatment

                                                          DIAGNOSTIC CHECKLIST

                                                          • Consider

                                                            • Image Interpretation Pearls

                                                              Selected References

                                                              1. Hunter LE et al: Atrioventricular block during fetal life. J Saudi Heart Assoc. 27(3):164-78, 2015
                                                              2. Mitchell JL et al: Fetal heart rate predictors of long QT syndrome. Circulation. 126(23):2688-95, 2012
                                                              3. Friedman DM et al: Utility of cardiac monitoring in fetuses at risk for congenital heart block: the PR Interval and Dexamethasone Evaluation (PRIDE) prospective study. Circulation. 117(4):485-93, 2008
                                                              4. Jaeggi ET et al: Diagnosis and management of fetal bradyarrhythmias. Pacing Clin Electrophysiol. 31 Suppl 1:S50-3, 2008
                                                              5. Lopes LM et al: Perinatal outcome of fetal atrioventricular block: one-hundred-sixteen cases from a single institution. Circulation. 2008 Sep 16;118(12):1268-75. Epub 2008 Sep 2. Erratum in: Circulation. 118(16): e671, 2008