585
edits
Bradycardia: Difference between revisions
no edit summary
No edit summary |
No edit summary |
||
| Line 108: | Line 108: | ||
* <b>Sinus node disease:</b> Pacemaker implantation should be considered in patients with sinus node disease which manifests as symptomatic bradycardia in which the symptom-rhythm correlation must have been 1) spontaneously occurring or 2) drug-induced where alternative drug therapy is lacking. Furthermore other eligible candidates for permanent pacing are patients with syncope with sinus node disease, either spontaneously occurring or induced at electrophysiological study and sinus node disease manifests as symptomatic chronotropic incompetence which is 1) spontaneously occurring or 2) drug-induced where alternative drug therapy. | * <b>Sinus node disease:</b> Pacemaker implantation should be considered in patients with sinus node disease which manifests as symptomatic bradycardia in which the symptom-rhythm correlation must have been 1) spontaneously occurring or 2) drug-induced where alternative drug therapy is lacking. Furthermore other eligible candidates for permanent pacing are patients with syncope with sinus node disease, either spontaneously occurring or induced at electrophysiological study and sinus node disease manifests as symptomatic chronotropic incompetence which is 1) spontaneously occurring or 2) drug-induced where alternative drug therapy. | ||
Patients with sinus node disease without symptoms including use of bradycardia-provoking drugs, ECG findings of sinus node dysfunction with symptoms not due directly or indirectly to bradycardia or symptomatic sinus node dysfunction where symptoms can reliably be attributed to non-essential medication do not have an indication for permanent pacemaker therapy. | Patients with sinus node disease without symptoms including use of bradycardia-provoking drugs, ECG findings of sinus node dysfunction with symptoms not due directly or indirectly to bradycardia or symptomatic sinus node dysfunction where symptoms can reliably be attributed to non-essential medication do not have an indication for permanent pacemaker therapy. | ||
* <b>Atrioventricular Block:</b> The following patients with AV conduction block have an indication for pacemaker therapy; 1) chronic symptomatic third or second degree (Mobitz I or II) atrioventricular block 2) neuromuscular diseases (e.g. myotonic muscular dystrophy | * <b>Atrioventricular Block:</b> The following patients with AV conduction block have an indication for pacemaker therapy; 1) chronic symptomatic third or second degree (Mobitz I or II) atrioventricular block 2) neuromuscular diseases (e.g. myotonic muscular dystrophy etc.) with third-degree or second-degree atrioventricular Block or 3) third or second degree (Mobitz I or II) atrioventricular block after catheter ablation of the atrioventricular junction or after valve surgery when the block is not expected to resolve. Patients with asymptomatic first degree atrioventricular block, asymptomatic second degree Mobitz I with supra-Hisian conduction block or atrioventricular block expected to resolve do not require a pacemaker implantation. | ||
etc.) with third-degree or second-degree atrioventricular Block or 3) third or second degree (Mobitz I or II) atrioventricular block after catheter ablation of the atrioventricular junction or after valve surgery when the block is not expected to resolve. Patients with asymptomatic first degree atrioventricular block, asymptomatic second degree Mobitz I with supra-Hisian conduction block or atrioventricular block expected to resolve do not require a pacemaker implantation. | |||
* <b>Intraventricular conduction Block:</b> Patient which show a intermittent third-degree atrioventricular block, second-degree Mobitz II atrioventricular block. alternating bundle branch block or findings on electrophysiological study of markedly prolonged His-Ventrical interval (≥100ms) or pacing-induced infra-His block in patients with symptoms have an indication for pacemaker therapy. Patients with a bundle branch block without atrioventricular block or symptoms and bundle branch block with first-degree atrioventricular block without symptoms should not have a pacemaker implanted. | * <b>Intraventricular conduction Block:</b> Patient which show a intermittent third-degree atrioventricular block, second-degree Mobitz II atrioventricular block. alternating bundle branch block or findings on electrophysiological study of markedly prolonged His-Ventrical interval (≥100ms) or pacing-induced infra-His block in patients with symptoms have an indication for pacemaker therapy. Patients with a bundle branch block without atrioventricular block or symptoms and bundle branch block with first-degree atrioventricular block without symptoms should not have a pacemaker implanted. | ||