What is the role of pacemaker implantation in the treatment of third-degree atrioventricular (AV) block?

Updated: Jul 05, 2018
  • Author: Akanksha Agrawal, MBBS; Chief Editor: Jeffrey N Rottman, MD  more...
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Unless the heart block is due to a medication that can be discontinued or an infectious process that can be effectively treated, most patients with acquired third-degree atrioventricular (AV) block (complete heart block) should receive a permanent pacemaker or an implantable cardioverter-defibrillator (ICD) (if a high risk of sudden cardiac death exists on the basis of severe left ventricular dysfunction or other criteria).

The ultimate decision whether to place a permanent pacemaker in patients with persistent heart block without a reversible cause depends on many factors. A clinical statement from the American College of Cardiology (ACC), the American Heart Association (AHA), and the Heart Rhythm Society (HRS) was published in 2008; this paper outlined the indications for permanent pacing. [20] A focused update of these guidelines was published in 2012 and is presented below. [21]

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