[Organization and management of acute complete atrioventricular block: Results from a Multicenter National Survey].
Organisation et gestion aiguë du bloc atrioventriculaire complet : résultats d’une enquête multicentrique nationale.
Adult
After-Hours Care
/ organization & administration
Aged
Algeria
Atrioventricular Block
/ therapy
Cardiotonic Agents
/ therapeutic use
Drug Resistance
France
Health Care Surveys
Heart Injuries
/ epidemiology
Hematoma
/ epidemiology
Humans
Isoproterenol
/ therapeutic use
Mali
Middle Aged
Monaco
Morocco
Pacemaker, Artificial
/ adverse effects
Prospective Studies
Prosthesis Implantation
/ adverse effects
Tunisia
Active fixation lead
Bloc atrioventriculaire complet
Complete atrioventricular block
Sonde de stimulation à fixation active
Sonde de stimulation électro-systolique
Stimulation temporaire
Temporary pacing lead
Journal
Annales de cardiologie et d'angeiologie
ISSN: 1768-3181
Titre abrégé: Ann Cardiol Angeiol (Paris)
Pays: France
ID NLM: 0142167
Informations de publication
Date de publication:
Apr 2021
Apr 2021
Historique:
received:
29
10
2020
accepted:
28
01
2021
pubmed:
2
3
2021
medline:
27
10
2021
entrez:
1
3
2021
Statut:
ppublish
Résumé
Complete atrioventricular block (AVB3) may be an urgent potentially lifethreatening situation. Our objective was to describe the routine management of AVB 3, with emphasis on the organizational aspects. From September 2019 to November 2019, a prospective national survey including 28 questions was electronically sent to 100 physicians (Google Form). The answers were collected from 93 physicians (response rate 93%). Permanent pacemaker implantation during weekends and nights (after 8PM) is possible for 49% of the operators (<5 times a year), for 15% (>5 times a year), impossible for 36% of the operators. For AVB3 nonresponsive to isoproterenol occurring during the night, a temporary pacing lead (TPL) is implanted by: the on-site medical staff on-duty (27%), the on-call interventional cardiologist (21%), the on-call electrophysiologist (19%), a permanent pacemaker is implanted by the electrophysiologist (12%), the strategy is not standardized (15%). An externalized active fixation lead (AFL) for AVB3 has already been implanted by 50% of the operators. 80 (86%) have already observed a dislocation of the TPL, a cardiac perforation already occurred in 57 (61%), a groin hematoma in 35 (38%), and this technique was proscribed for 4% of the operators. Our survey shows important disparities in terms of management of AVB3 among the different centers. An externalized AFL with a reusable generator was used by half of the centers.
Sections du résumé
BACKGROUND
BACKGROUND
Complete atrioventricular block (AVB3) may be an urgent potentially lifethreatening situation. Our objective was to describe the routine management of AVB 3, with emphasis on the organizational aspects.
METHODS
METHODS
From September 2019 to November 2019, a prospective national survey including 28 questions was electronically sent to 100 physicians (Google Form).
RESULTS
RESULTS
The answers were collected from 93 physicians (response rate 93%). Permanent pacemaker implantation during weekends and nights (after 8PM) is possible for 49% of the operators (<5 times a year), for 15% (>5 times a year), impossible for 36% of the operators. For AVB3 nonresponsive to isoproterenol occurring during the night, a temporary pacing lead (TPL) is implanted by: the on-site medical staff on-duty (27%), the on-call interventional cardiologist (21%), the on-call electrophysiologist (19%), a permanent pacemaker is implanted by the electrophysiologist (12%), the strategy is not standardized (15%). An externalized active fixation lead (AFL) for AVB3 has already been implanted by 50% of the operators. 80 (86%) have already observed a dislocation of the TPL, a cardiac perforation already occurred in 57 (61%), a groin hematoma in 35 (38%), and this technique was proscribed for 4% of the operators.
CONCLUSION
CONCLUSIONS
Our survey shows important disparities in terms of management of AVB3 among the different centers. An externalized AFL with a reusable generator was used by half of the centers.
Identifiants
pubmed: 33642047
pii: S0003-3928(21)00024-X
doi: 10.1016/j.ancard.2021.01.007
pii:
doi:
Substances chimiques
Cardiotonic Agents
0
Isoproterenol
L628TT009W
Types de publication
Journal Article
Multicenter Study
Langues
fre
Sous-ensembles de citation
IM
Pagination
68-74Informations de copyright
Copyright © 2021 Elsevier Masson SAS. All rights reserved.