This study aimed to evaluate a new ECG index, the 'vagal score (VS),' to determine the mechanism of P-AVB. Sayaka Komatsu, MDa, Masataka Sumiyoshi, MDb,n, Seiji Miura, MDa, Yuki Kimura, MDb, Tomoyuki Shiozawa, MDa, Keiko Hirano, MDa, Fuminori Odagiri, MDc, Haruna Tabuchi, MDa, Hidemori Hayashi, MDa, Gaku Sekita, MDa, Takashi Tokano, MDc, Yuji Nakazato, MDc, Hiroyuki Daida, MDaĪ Department of Cardiology, Juntendo University School of Medicine, 2-1-1 Hongo, Bunkyo-ku, Tokyo 113-8431, Japan b Department of Cardiology, Juntendo University Nerima Hospital, Tokyo, Japan c Department of Cardiology, Juntendo University Urayasu Hospital, Urayasu, Japanīackground: Paroxysmal atrioventricular block (P-AVB) is a well-known cause of syncope however, its underlying mechanism is difficult to determine. P-AVB with a VS ≥3 strongly suggested a vagally mediated mechanism.Ĭontents lists available at ScienceDirectĪ proposal of clinical ECG index 'vagal score' for determining the mechanism of paroxysmal atrioventricular block The VS is simple and potentially useful for determining the mechanism of P-AVB.

We observed characteristic ECG findings of ICD consisting of changes in AV conduction by an extrasystole and/or escape beat in only 5 of the 6 patients (83%) with a low VS (1 to –2). Five patients with a definite vagally mediated P-AVB had high VSs (3–5 points). The VS ranged from 5 to –2 points for each patient. Based on the clinical situations and electrophysiologic findings, we considered the mechanism of P-AVB as vagally mediated or intrinsic conduction disease (ICD). The VS was developed by assigning 1 point each for the following: (1) no AVB or intraventricular conduction disturbance on the baseline ECG, (2) PR prolongation immediately before P-AVB, (3) sinus slowing immediately before P-AVB, (4) initiation of P-AVB by PP prolongation, (5) sinus slowing during ventricular asystole, and (6) resumption of AV conduction with PP shortening, and by assigning –1 point each for (7) the initiation of P-AVB by a premature beat, and (8) resumption of AV conduction by an escape beat. We evaluated the VS in 20 patients with P-AVB (13 men, 7 women aged 25–78 years ).

This study aimed to evaluate a new ECG index, the “vagal score (VS),” to determine the mechanism of P-AVB. Wa_cq_url: '/content/Paroxysmal atrioventricular block (P-AVB) is a well-known cause of syncope however, its underlying mechanism is difficult to determine. Wa_audience: 'emtaudience:business/btssbusinesstechnologysolutionspecialist/developer/fpgaengineer', Wa_emtsubject: 'emtsubject:design/fpgadesign/quartusdesignflow/designimplementation', Wa_curated: 'curated:donotuseinexternalfilters/developmentsoftware', Wa_primarycontenttagging: 'primarycontenttagging:intelfpgas/intelprogrammabledevices/intelstratix/intelstratix10fpgasandsocfpgas,primarycontenttagging:intelfpgas/intelprogrammabledevices/intelagilexfpgasandsocfpgas/intelagilex7fpgasandsocfpgas,primarycontenttagging:intelfpgas/intelprogrammabledevices/intelarria/intelarria10fpgasandsocfpgas,primarycontenttagging:intelfpgas/intelprogrammabledevices,primarycontenttagging:intelfpgas/intelprogrammabledevices/intelcyclone/intelcyclone10fpgas/intelcyclone10gxfpga,primarycontenttagging:intelfpgas/intelquartussoftware/intelquartusprimedesignsoftware/intelquartusprimeproedition', Wa_emtcontenttype: 'emtcontenttype:designanddevelopmentreference/applicationnote',

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