According to ACC-AHA-HRS guidelines, when is permanent pacemaker implementation a reasonable treatment of atrioventricular (AV) block?

Updated: Jul 05, 2018
  • Author: Akanksha Agrawal, MBBS; Chief Editor: Jeffrey N Rottman, MD  more...
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Permanent pacemaker implantation is reasonable for the following [21] :

  • Persistent third-degree AV block with an escape rate faster than 40 beats/min in asymptomatic adult patients without cardiomegaly
  • Asymptomatic second-degree AV block at intra- or infra-His levels found at electrophysiologic study
  • First- or second-degree AV block with symptoms similar to those of pacemaker syndrome or hemodynamic compromise
  • Asymptomatic Mobitz II second-degree AV block with a narrow QRS; when Mobitz II second-degree AV block occurs with a wide QRS, including isolated right bundle-branch block, pacing becomes a class I recommendation

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