Indications for Permanent Pacing

(JACC 2013;61:e6 & 2017;70:e39, Circ 2019;140:e382)

AV block

2° type II, high-grade or 3° AVB; symptomatic 1°, 2° type I AVB or asx with Lamin A/C or neuromuscular disease; bifasc or alter. L & RBBB

Sinus node

SB, pauses (SSS), chronotrop incompet a/w sx or ? if sx w/o clear assoc

Tachy-arrhythmia

AF w/ SSS; sx recurrent SVT term. by pacing after failing drugs/ablation; Sustained pause-dependent VT; ? high-risk congenital long QT

Syncope

Carotid sinus hypersensitivity with asystole >3 sec Syncope with bi- or trifascicular block and HV>70 ms on EP study ? Recurrent vasovagal syncope w/ abnormal tilt test (JACC 2017;70:1720)