Section of Cardiac Electrophysiology, Division of Cardiology, University of California San Francisco, MU-East 4th Floor, 500 Parnassus Avenue, San Francisco, CA 94143, USA.
UCLA Cardiac Arrhythmia Center, University of California Los Angeles, Center of the Health Science, #46-131, 650 Charles E. Young Drive South, Los Angeles, CA 90095, USA.
Card Electrophysiol Clin. 2021 Dec;13(4):711-720. doi: 10.1016/j.ccep.2021.06.010. Epub 2021 Sep 25.
Iatrogenic atrioventricular (AV) block can occur in the context of cardiac surgery, percutaneous transcatheter, or electrophysiologic procedures. In cardiac surgery, patients undergoing aortic and/or mitral valve surgery are at the highest risk for developing perioperative AV block requiring permanent pacemaker implantation. Similarly, patients undergoing transcatheter aortic valve replacement are also at increased risk for developing AV block. Electrophysiologic procedures, including catheter ablation of AV nodal re-entrant tachycardia, septal accessory pathways, para-Hisian atrial tachycardia, or premature ventricular complexes, are also associated with risk of AV conduction system injury. In this article, we summarize the common causes for iatrogenic AV block, predictors for AV block, and general management considerations.
医源性房室（AV）阻滞可发生于心脏手术、经皮介入或电生理程序中。在心脏手术中，主动脉瓣和/或二尖瓣手术的患者发生围手术期 AV 阻滞需要永久性起搏器植入的风险最高。同样，行经导管主动脉瓣置换术的患者发生 AV 阻滞的风险也增加。电生理程序，包括房室结折返性心动过速、间隔旁道、希氏旁道房性心动过速或室性期前收缩的导管消融，也与 AV 传导系统损伤的风险相关。本文总结了医源性 AV 阻滞的常见原因、AV 阻滞的预测因素以及一般管理注意事项。
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