Permanent cardiac pacing: Overview of devices and indications
- David L Hayes, MD
David L Hayes, MD
- Professor of Medicine
- Mayo Medical School
Cardiac pacemakers are effective treatments for a variety of bradyarrhythmias. By providing an appropriate heart rate and heart rate response, cardiac pacing can reestablish effective circulation and more normal hemodynamics that are compromised by a slow heart rate.
This topic will present a broad review of the role of cardiac pacing in a variety of settings. The management of the specific disorders is discussed separately as is a description of the different types of pacemakers and pacing modes. (See "Sick sinus syndrome: Treatment" and "Third degree (complete) atrioventricular block" and "Second degree atrioventricular block: Mobitz type II" and "Modes of cardiac pacing: Nomenclature and selection".)
Despite the myriad of clinical situations in which permanent pacing is considered, most management decisions regarding permanent pacemaker implantation are driven by the following clinical factors:
●The association of symptoms with a bradyarrhythmia
●The location of the conduction abnormalityTo continue reading this article, you must log in with your personal, hospital, or group practice subscription. For more information on subscription options, click below on the option that best describes you:
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- GENERAL PRINCIPLES
- Location of conduction abnormality
- Reversible causes
- Concurrent ICD
- TYPES OF PERMANENT PACEMAKER SYSTEMS
- Pulse generators
- Transvenous systems
- Epicardial systems
- Leadless systems
- COMMON INDICATIONS
- Sinus node dysfunction
- - Class I
- - Class II
- Acquired AV block
- - Class I
- - Class II
- Post myocardial infarction
- Neurally-mediated syncope
- OTHER INDICATIONS
- Congenital complete heart block
- Neuromuscular diseases
- Long QT syndrome
- - Bradycardia-induced ventricular arrhythmias
- Hypertrophic cardiomyopathy
- Heart failure
- CLASS III: PACING NOT INDICATED
- SOCIETY GUIDELINE LINKS
- INFORMATION FOR PATIENTS
- SUMMARY AND RECOMMENDATIONS