| Type of AV Block |
Pacemaker Necessary |
Pacemaker Probably Necessary |
Pacemaker Not Necessary |
| Third |
Symptomatic congenital heart block (CHB) |
|
AV block of
any degree that is expected to resolve and unlikely to recur (e.g., drug
toxicity, Lyme disease, sleep apnea) without treatment |
| Acquired symptomatic atrioventricular (AV) block |
| Atrial fibrillation with CHB |
| Acquired asymptomatic CHB |
| Neuromuscular diseases with AV block, with or without
symptoms |
| Second |
| |
|
Symptomatic
second-degree AV block, regardless of type |
| |
|
Asymptomatic
advanced second-degree AV block with asystole > 3.0 sec or escape rate <
40 beats/min in awake patients |
|
| |
|
Asymptomatic,
type I, at intra-His or infra-His level[*] |
| |
|
Hemodynamically
symptomatic caused by loss of AV synchrony |
| |
|
Neuromuscular
diseases with AV block, with or without symptoms
|
|
Asymptomatic, type I, at supra-His (AV node) level |
| First |
|
Hemodynamically symptomatic caused by loss of AV synchrony with
markedly prolonged PR interval (e.g., >300 msec) |
Asymptomatic |
Referensi:
Braunwald's Heart Disease 8E (Saunders) 2007