Step II Post MI Bradycardia

[adagio]

I read that all PostMI bradycardias are treated FIRSTLY with atropine THEN with pace maker if atropine do not help ... my question here is:

if we have 3rd degree heart block, do we follow this rule!??! arent we supposed to do pacing ALWAYS after atropine? what if atropine relieves the problem now? shouldnt we put a pacemaker anyway?

 

[Fuzuli]

I read that all PostMI bradycardias are treated FIRSTLY with atropine THEN with pace maker if atropine do not help ... my question here is:

if we have 3rd degree heart block, do we follow this rule!??! arent we supposed to do pacing ALWAYS after atropine? what if atropine relieves the problem now? shouldnt we put a pacemaker anyway?

You're correct; all second degree type II and third degree AV blocks should have temporary pacing. So both a) Being refractory to atropine and b) type II second-degree + third degree AV blocks are indications for temporary pacing. All post-MI patients with sinus bradycardia who has other cardiac symptoms (hypotension, angina, syncope, CHF) should also have temporary pacing.

 

[adagio]

So you agree on the point that despite 3rd block needing pacemaker, we should administer atropine first and THEN put a pacemaker (no matter what effect the atropine has)

 

[Fuzuli]

So you agree on the point that despite 3rd block needing pacemaker, we should administer atropine first and THEN put a pacemaker (no matter what effect the atropine has)

Exactly.

 

[adagio]

🙂 good thanks a A TON