HRS/ACCF Expert Consensus Statement on Pacemaker Device and Mode Selection


The following are 10 points to remember from this consensus statement on pacemaker device and mode selection in patients deemed to be appropriate candidates for a permanent pacemaker:

1. Dual-chamber (DDD) pacing is recommended over single-chamber atrial (AAI) pacing and single-chamber ventricular (VVI) pacing in patients with sinus node dysfunction (SND).

2. Rate-adaptive pacing can be useful in patients with SND and chronotropic incompetence.

3. Minimization of ventricular pacing in patients with SND and intact atrioventricular (AV) conduction can prevent atrial fibrillation.

4. AAI pacing may be considered in selected patients with SND and normal AV conduction.

5. DDD pacing is recommended in patients with AV block.

6. Single-lead synchronized ventricular pacing with dual-chamber sensing (VDD) can be useful in patients with AV block and no SND.

7. DDD or VVI pacing can be useful for carotid sinus syndrome.

8. DDD pacing can be useful for neurocardiogenic syncope.

9. DDD or AAI pacing is recommended over VVI pacing for symptomatic or high-risk patients with congenital long QT syndrome.

10. DDD pacing can be useful for patients with symptomatic hypertrophic cardiomyopathy and significant outflow tract obstruction refractory to medical therapy.

Clinical Topics: Arrhythmias and Clinical EP, Congenital Heart Disease and Pediatric Cardiology, Heart Failure and Cardiomyopathies, Genetic Arrhythmic Conditions, SCD/Ventricular Arrhythmias, Congenital Heart Disease, CHD and Pediatrics and Arrhythmias

Keywords: Cardiomyopathy, Hypertrophic, Long QT Syndrome, Pacemaker, Artificial

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