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Cardiac Pacing for the Clinician pp 407–427Cite as

Acquired Atrioventricular Block

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There are many causes of atrioventricular (AV) block but progressive idiopathic fibrosis of the conduction system related to an aging process of the cardiac skeleton is the most common cause of chronic acquired AV block. Barring congenital AV block, Lyme disease is the most common cause of reversible third-degree AV block in young individuals and it is usually AV nodal. Before implantation of a permanent pacemaker, reversible causes of AV block such as Lyme disease, hypervagotonia, athletic heart, sleep apnea, ischemia, and drug, metabolic, or electrolytic imbalance must be excluded. Table 10.1 outlines the format used in the 2002 American College of Cardiology/American Heart Association/North American Society of Pacing and Electrophysiology (ACC/AHA/NASPE) guidelines for pacemaker implantation (1). The indications for permanent pacing in second- or third- degree AV block unlikely to regress are often straightforward in symptomatic patients but they are more difficult in asymptomatic patients.

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Author information

Authors and Affiliations

  1. Division of Cardiology, University of South Florida College of Medicine, 33615, Tampa, FL, USA

    S. Serge Barold MD, FRACP

  2. Cardiac Electrophysiology and Arrhythmia Service, University of South Florida College of Medicine, 33615, Tampa, FL, USA

    Bengt Herweg MD

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  1. S. Serge Barold MD, FRACP
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Editors and Affiliations

  1. Mayo Clinic, 32224, Jacksonville, FL, USA

    Fred M. Kusumoto MD

  2. University of California San Francisco School of Medicine, San Francisco, CA, USA

    Nora F. Goldschlager MD

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Barold, S.S., Herweg, B. (2008). Acquired Atrioventricular Block. In: Kusumoto, F.M., Goldschlager, N.F. (eds) Cardiac Pacing for the Clinician. Springer, Boston, MA. https://doi.org/10.1007/978-0-387-72763-9_10

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  • DOI: https://doi.org/10.1007/978-0-387-72763-9_10

  • Publisher Name: Springer, Boston, MA

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