Pediatric Second-Degree Atrioventricular Block Medication

Updated: Sep 11, 2019
  • Author: M Silvana Horenstein, MD; Chief Editor: Syamasundar Rao Patnana, MD  more...
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Medication

Medication Summary

In general, patients with second-degree atrioventricular (AV) block with symptomatic bradycardia may be medicated with intravenous isoproterenol or atropine acutely. However, these agents must be administered in a hospital setting with cardiac monitoring available. Patients with Mobitz I (Wenckebach) AV block secondary to increased vagal tone may respond to theophylline, glycopyrrolate, or scopolamine. Pacemaker therapy is required when medications fail to control symptoms.

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Beta-adrenergic agonists

Class Summary

Isoproterenol has beta1-adrenergic and beta2-adrenergic receptor activity. It binds beta receptors of the heart, smooth muscle of bronchi, skeletal muscle, vasculature, and alimentary tract. Isoproterenol has positive inotropic and chronotropic actions.

Isoproterenol (Isuprel)

Isoproterenol is usually given as a continuous intravenous infusion for rate support. It is usually administered as a temporizing measure, initiated during the organization of temporary or permanent pacing system placement for symptomatic patients with bradycardia from heart block or sinus node disease.

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Anticholinergics

Class Summary

The goal of anticholinergic therapy is to improve AV node conduction by reducing vagal tone via the muscarinic receptor blockade. This is effective only if the site of a block is within the AV node. Anticholinergic therapy is ineffective for patients with infranodal block.

Atropine

Atropine is administered to increase heart rate through vagolytic effects, causing an increase in cardiac output.

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