Bradycardia and Adams–Stokes Syndrome

Short-Term Treatment of Persistent Bradycardia Due to Atrioventricular Block

Atrioventricular (AV) block is a disorder of the heart’s electrical conduction system in which the transmission of electrical impulses from the atria to the ventricles is delayed or interrupted. In severe cases, it may result in significant bradycardia and reduced cardiac output.

Symptoms

Symptoms vary depending on the severity of the conduction disturbance and may include:

Dizziness or lightheadedness

Marked fatigue

Shortness of breath

Syncope

Hypotension

Causes and Risk Factors

AV block may result from degenerative changes in the cardiac conduction system, ischemic heart disease, acute myocardial infarction, congenital heart disease, or the use of medications that slow atrioventricular conduction.

Diagnosis

Diagnosis is based primarily on an electrocardiogram (ECG). In selected cases, continuous ambulatory ECG monitoring (Holter monitoring) or additional cardiological investigations may be required.

Management

Permanent pacemaker implantation is the treatment of choice for most patients. However, when pacemaker implantation is not immediately feasible or is temporarily contraindicated, short-term pharmacological therapy may be administered to maintain an adequate heart rate until definitive treatment can be provided.

Conclusion

Early recognition of symptomatic bradycardia and appropriate short-term management can help stabilize the patient and reduce the risk of serious complications.

Short-Term Treatment of Adams–Stokes Syndrome

Adams–Stokes syndrome is a serious clinical condition characterized by sudden episodes of loss of consciousness caused by transient cardiac standstill or a marked slowing of the heart rate. It is most commonly associated with high-grade atrioventricular block or other severe bradyarrhythmias.

Symptoms

The most common symptoms include:

Sudden syncope

Dizziness

Pallor

Bradycardia

Sudden collapse without warning

Causes and Risk Factors

The most common cause is complete or advanced atrioventricular block. The syndrome may also occur in patients with severe sinus node dysfunction or other disorders affecting the cardiac conduction system.

Diagnosis

Diagnosis is based on the patient’s clinical history, electrocardiographic findings, and, when indicated, prolonged cardiac rhythm monitoring to document the underlying arrhythmia.

Management

Immediate management aims to stabilize the patient’s heart rate and hemodynamic status. Until definitive treatment with permanent pacemaker implantation can be performed, short-term pharmacological therapy may be administered according to the patient’s clinical condition.

Conclusion

Adams–Stokes syndrome is a cardiac emergency requiring prompt recognition and immediate therapeutic intervention. Early diagnosis and appropriate short-term management can help prevent serious complications until definitive treatment is achieved.