# Complete heart block
- *** Failed atropine
- Recommend holding all AVN blocking agents (BB & CCBs)
- *** The patient will be monitored on telemetry for further bradycardia. Nursing staff will periodically monitor pacing threshold of temporary pacemaker and will alert physicians of any change in threshold.
- *** Keep transcutaneous pacemaker on patient at *** 60 BPM
- *** Dopamine 5 and titrate up to 10 for persistent symptomatic bradycardia
- No need for emergent tranvenous pacing given her stability; however, in the event that @HE@ decompensates, please page cardiology fellow for immediate transvenous pacing.
- Maintain Mg >2 & K >4
- Trend troponins q6h until downtrending.
- Will likely need an ischemic evaluation with MIBI v. LHC once stable.
- Obtain formal echo in the AM to determine systolic function.
- Consult EP in the AM about need for permanent pacemaker placement.
- Anticipate that if systolic function on echocardiogram is normal or near normal, the patient will undergo permanent pacemaker placement in AM.
- NPO at midnight