Third degree AV block surgery: Difference between revisions
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{{Third degree AV block}} | {{Third degree AV block}} | ||
{{CMG}}; {{AE}} {{CZ}}; {{RT}} | {{CMG}}; {{AE}} {{CZ}}; {{RT}} | ||
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Revision as of 16:18, 17 February 2013
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Cafer Zorkun, M.D., Ph.D. [2]; Raviteja Guddeti, M.B.B.S. [3]
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Surgery
Implantation of permanent pacemakers in both asymptomatic and symptomatic patients is usually done. Asymptomatic Mobitz II are prone to be converted to symptomatic or third degree heart AV block. Thus, they should be considered for a pacemaker even if asymptomatic.
Pacemaker Indications
Permanent pacemaker implantation indications in complete heart block include:
- Symptomatic complete heart block
- ≥3 ventricular pauses
- Resting heart rate <40 beats per minute while awake
- Certain neuromuscular diseases which have a high potential for unpredictable rapid progression of conduction blocks
Pacing Mode
VVI pacing mode was widely used in the past. But this mode has been shown to be associated with AV dyssynchrony leading to pacemaker syndrome. A dual chamber DDD pacemaker is preferred over a single chambered VVI pacemakers as it maintains physiologic AV synchrony. A dual-chamber artificial pacemaker is a type of device that typically listens for a pulse from the SA node and sends a pulse to the AV node at an appropriate interval, essentially completing the connection between the two nodes. Pacemakers in this role are usually programmed to enforce a minimum heart rate and to record instances of atrial flutter and atrial fibrillation , two common secondary conditions that can accompany third degree AV block.