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Bradycardia Diagnostic and Management Algorithm

CONSIDER ETIOLOGY (not inclusive): 
 - STRUCTURAL: sick sinus, AV block, ischemia,
sick sinus, AV block ... Hypothyroidism - TOX: beta-blockers ... LIFE THREATENING CAUSES ... TREATMENT - Drugs (beta-blockers ... #Differential
Syncope - Differential Diagnosis Framework
Reflex Syncope:
• Vasovagal: Prolonged standing, Stress, Pain
• Situational: Coughing, Sneezing, Micturition, Defecation,
Syncope - Differential ... Medication Effect: a-blockers ... bradycardia, Sinus pauses ... , AV block • Tachyarrhythmias ... #Differential #
Shock - Differential Diagnosis by Classification
Reflex Syncope 
 - Vasovagal syncope
   • Prolonged standing
Shock - Differential ... • AV block ... side effect (e.g. αblockers ... #Differential # ... Classification #Table #Causes
Syncope - Differential Diagnosis
The percentage of syncopal events secondary to arrhythmias or structural disease is generally
Syncope - Differential ... percentage of syncopal ... Sick sinus, AV block ... #differential # ... diagnosis #causes
Differential Diagnosis of Syncope
First, is it syncope? History is very important for distinguishing syncope from other
Differential Diagnosis ... from other causes ... Common causes of ... #Causes #Differential ... #Algorithm #Ddxof
Pacemaker Placement Indications
Class I:
 • Third degree block
 • Advanced 2nd degree block
 • Symptomatic Mobitz
• Third degree block ... Advanced 2nd degree block ... or 3rd degree block ... • Reversible causes ... of AV block -
Syncope - Differential Diagnosis Algorithm
Neurocardiogenic:
 • Vasovagal
 • Orthostatic Hypotension
 • Autonomic Neuropathy
 • Situational (micturition,
Syncope - Differential ... Diagnosis Algorithm ... /3rd degree AV Block ... #Diagnosis #Algorithm ... #causes
Causes of Syncope #Diagnosis #EM #IM #Neuro #Syncope #Differential #Algorithm #Ddxof
Causes of Syncope ... EM #IM #Neuro #Syncope ... #Differential # ... Algorithm #Ddxof
Antiarrhythmics - Vaughan Williams Classification:
CLASS 1 - Sodium Channel Blockers:
 • MOA: Block fast Na+ channels
: • MOA: Block ... duration CLASS 2 - Beta ... : • MOA: Block ... primarily) and block ... : • MOA: Block
WOBBLER  for ECG assessment in Syncope 
W - Wolff Parkinson White 
O - Obstructed AV
- Bifascicular block ... or 3rd degree block ... B bifascicular block ... bundle branch block ... , can be caused