Therapeutic target
To prevent heart failure (cardiac insufficiency) and sudden cardiac death resulting from severe bradycardia (bradycardia: heart rate below 60 beats per minute).
Therapy recommendations
- Acute therapy:
- Atropine (parasympatholytic) for high-grade bradycardia in 1st-degree AV block (AV I; delayed conduction time between atrium and ventricle); alternatively, orciprenaline (sympathomimetic; off-label use/use outside the indications or group of people for which the drugs are approved by drug authorities)
- High-grade AV block in Lyme carditis: ceftriaxone i.v. until PQ interval is less than 300 ms; in severe cases, a passaged pacemaker may be required. (see below Lyme disease).
- Immediate hospitalization is advised if the 12-lead ECG shows 2nd degree or 3rd degree AV block!
- Pacemaker therapy – in addition to discontinuation of potentially triggering conduction-delaying drugs – is the method of choice.
