Mobitz I AV Block: Why and When to Pace?
The presence of symptoms related to bradyarrhythmia is one of the basic conditions in which there is general agreement in favor of permanent cardiac pacemaker implantation. In patients with Mobitz I atrioventricular (AV) block, clinical manifestations such as transient dizziness, light-headedness, near-syncope, or more generalized symptoms related to exercise tolerance or congestive heart failure, are considered a class I indication for permanent pacing in the guidelines of 1991 ACC/AHA Task Force . In the same guidelines, pacing in asymptomatic subjects with Mobitz type I AV block is indicated, with some divergence of opinion (class II condition), only if an intra- or infra-His bundle block is demonstrated, while there is no indication (class III condition) when the block is at nodal level. In these guidelines relief of symptoms is the only therapeutic goal of pacing, while other aims, such as improved outcome, are not considered since the prognostic role of pacing in the Mobitz I AV block has not yet been fully assessed.
KeywordsAtrioventricular Block Structural Heart Disease Pacemaker Implantation Underlying Heart Disease Nodal Block
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