Table 8

Conduction Disturbances and Arrhythmias

>Up to 72 h, continuous rhythm monitoring is recommended in order to maximize the detection of arrhythmias
Data elements to be collected should include
 Baseline conduction abnormalities, paroxysmal or permanent atrial fibrillation (or flutter), and the presence of permanent pacemaker
 Implant-related new or worsened cardiac conduction disturbance (new or worsened first-degree atrioventricular (AV) block, second-degree AV block (Mobitz I or Mobitz II), third-degree AV block, incomplete right bundle branch block, right bundle branch block, intraventricular conduction delay, left bundle branch block, left anterior fascicular block, or left posterior fascicular block, including block requiring a permanent pacemaker implant
 Persistent or transient high-degree AV block. High-grade AV block is persistent if it is present every time the underlying rhythm is checked
 New permanent pacemaker implantation, with precision of the indication and the number of days post-implant of the placement of new permanent pacemaker
 New-onset atrial fibrillation (or flutter)
 Any new arrhythmia resulting in hemodynamic instability or requiring therapy
  • Type of permanent pacemaker should be recorded (e.g. defibrillator, single vs. dual chamber, biventricular).

  • New-onset atrial fibrillation (or flutter) is diagnosed as any arrhythmia within hospitalization that has the ECG characteristics of atrial fibrillation (or flutter) and lasts sufficiently long to be recorded on a 12-lead ECG, or at least 30 s on a rhythm strip.

  • Therapy includes electrical/medical cardioversion or initiation of a new medication (oral anticoagulation, rhythm, or rate controlling therapy).