HANDBOOK OF CARDIAC PACING – PART 6

Sổ tay của nhịp tim rung tâm nhĩ hoặc rung động với block tim hoàn chỉnh hoặc AV khối tiên tiến và nhịp tim chậm không liên quan đến thuốc digitalis hoặc khác (trừ khi cần thiết), với bất kỳ các điều kiện ghi nhận | 72 Handbook of Cardiac Pacing 8 Atrial fibrillation or flutter with complete heart block or advanced AV-block and bradycardia unrelated to digitalis or other drugs unless needed with any of the conditions noted for complete AV-block Persistent advanced 2nd degree AV block below the AV-node with bilateral bundle branch block or complete AV-block after acute myocardial infarction Persistent symptomatic advanced 2nd or 3rd degree AV block distal conduction system after acute myocardial infarction Transient advanced AV block and associated bilateral bundle branch block postmyocardial infarction Documented symptomatic sinus bradycardia possibly due to long term essential drug therapy for which there is no reasonable alternative Symptomatic chronotropic incompetence inability to increase heart rate appropriately in response to physiology and or metabolic demands Recurrent syncope with clear spontaneous events provoked by carotid sinus stimulation minimal carotid sinus pressure causing a pause greater than 3 seconds Bi- or trifascicular block and intermittent complete or Mobitz-II AV block with or without symptoms Sustained pause dependent ventricular tachycardia. The efficacy of pacing must be documented. CLASS II DEVICES FREQUENTLY USED BUT SOME DIVERGENCE OF OPINION WITH RESPECT TO THE NECESSITY OF THEIR INSERTION Class IIA weight of evidence opinion is in favor of usefulness efficacy Asymptomatic complete heart block at any anatomic level of the conduction system and ventricular rates of 40 bpm or faster Asymptomatic Mobitz II block permanent or intermittent Asymptomatic Mobitz I at the intra-His or infra-His levels First degree AV block with symptoms suggestive of pacemaker syndrome and documented correction of symptoms with temporary AV pacing Heart rate less than 40 bpm without a clear correlation between symptoms and the bradycardia Recurrent syncope but no clear provocative events and hypersensitive CS response Syncope of unknown origin with major abnormalities .