Pacing Indications Flashcards
Chronotropic incompetence
Class 1
Symptomatic sinus bradycardia with symptoms but not documented
Class 2a
Syncope of unexplained origin but Sinus abnormalities discovered after EP study
Class 2a
Symptomatic sinus bradycardia as a result of a necessary drug
Class 1
indication that is not necessarily an outright contraindication to pacing, but it suggests that the risk is equal to the benefit
Class 2b
minimally symptomatic patients with chronic heart rates less than 40 bpm
Class 2b
sinus node dysfunction (even if it can be documented) if the patient is asymptomatic
Class III
patient with sinus node dysfunction and symptoms of brady- cardia, if there is documented evidence that those symptoms occur in the absence of bradycardia
Class III
patient takes non essential drug therapy and, as a result, develops documented sinus bradycardia with symptoms
Class III
Third-degree or advanced second-degree AV block at any anatomic level with symptomatic bradycardia
Class I
third-degree or advanced second-degree AV block at any anatomic level associated with arrhythmias and other medical conditions that require drug therapy that results in symptomatic bradycardia
Class 1 (The drug therapy must be required and essential.)
third-degree or advanced second-degree AV block plus at least one of the following: pauses(3 secs or more), bradycardia, or an escape rate originating below the AV node (less than 40bpm)
Class I
third-degree or advanced second-degree AV block is AV block at any anatomic level following catheter ablation of the AV junction
Class I
third-degree or advanced second-degree AV block at any anatomic level that is associated with post- operative AV block and is not expected to resolve after cardiac surgery
Class I
third-degree or advanced second-degree AV block at any anatomic level associated with
neuromuscular diseases such as Kearns–Sayre syndrome, Erb dystrophy, and peroneal muscular atrophy.
ClassI
Second-degree AV block associated with symp- tomatic bradycardia, regardless of the type of site of the block.
Class I
Asymptomatic persistent third-degree AV block at any anatomic site with an average awake ventric- ular rate of 40 bpm or higher if one or more of the following are present: cardiomegaly or left ventric- ular dysfunction or the block site is below the AV node. In this case, the patient has third-degree AV block but no symptoms and must have cardiomeg- aly (enlarged heart), some type of pump compro- mise (left ventricular dysfunction), or an AV block site below the AV node. AV block sites below the AV node are more common in advanced AV block.
Class I
Second-degree or third-degree AV block during exercise in the absence of myocardial infarction. In acute myocardial infarction, symptomatic brady- cardia can be transient, that is, it may go away on its own. For such patients, temporary pacing may be a preferable option.
Class I
Asymptomatic second-degree type II AV block with a wide QRS
Class I
Asymptomatic second-degree type II AV block with a narrow QRS
Class IIa
SSS with documented symptomatic bradycardia
Class 1
