Heart Block 07/24/2017

Heart Block 1Heart Block 7

Heart Block 8

  • Two General Indications for permanent pacemaker (PPM) implantation 
    • 1) Symptomatic sinus bradycardia with rate <40bpm
    • 2) High grade or symptomatic AV block
  • Pacing is generally not indicated in asymptomatic sinus bradycardia

Heart Block 2

Heart Block 3

  • There are Four main rhythms that are seen with DDD
    • 1) Normal sinus rhythm
      • pacemaker is totally inhibited due to acceptable intrinsic sinus rate and AV conduction
    • 2) Atrial sensing and ventricular pacing
      • Sinus rate is above the set rate (inhibited atrial pacing) with prolonged AV conduction (triggered ventricular pacing)
    • 3) Atrial pacing, normally conducted to the ventricle with native QRS
      • Atrial pacing is triggered by sinus bradycardia in the setting of normal AV conduction (inhibited ventricular pacing)
    • 4) AV sequential pacing
      • Both atrial and ventricular pacing are triggered due to sinus brady and prolonged AV conduction

Heart Block 4Heart Block 5Heart Block 6

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