Atrioventricular Dissociation Treatment & Management
- Author: Chirag M Sandesara, MD; Chief Editor: Jeffrey N Rottman, MD more...
Treatment depends on the underlying condition and its severity. The important considerations and steps in the treatment of patients with AV dissociation include the hemodynamic status of the patient and recognition of the underlying pathology.
For patients who are hemodynamically unstable, ie, patients with ventricular tachycardia, the initial treatment of choice is direct-current cardioversion or intravenous drug therapy, depending on the stability of the patient. Treatment of digoxin toxicity should also be pursued.
Ascertaining if AV conduction is intact is important in patients with AV dissociation due to an accelerated junctional rhythm following cardiac surgery. Rarely, patients have complete AV block with an accelerated focus distal to the level of block; when the accelerated focus becomes quiescent, heart block is present.
Monitor patients closely for medications that can cause AV dissociation.
Correct electrolyte imbalances.
A permanent pacemaker is rarely necessary.
Patients with unexplained or uncorrected persistent symptomatic AV dissociation due to an escape rhythm or ventricular tachycardia may require referral to an electrophysiologist or a cardiologist.
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