Mobitz Type I and First Degree AV Block: When to Permanently Pace?

  • L. Padeletti
  • A. Michelucci
  • P. Ticci
  • P. Pieragnoli


Permanent cardiac pacing has experienced an increase in indications, applications and numerous worldwide implantations. This has happened thanks to a constant technological advancement in hardware, available pacing mode choices, and an increasingly sophisticated multiprogrammability.


Pacemaker Implantation Permanent Pacemaker Organic Heart Disease Inappropriate Sinus Tachycardia Permanent Pace 
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  1. 1.
    Frye RL, Collins JJ, De Sanctis RW et al (1984) Guidelines for permanent cardiac implantation, May 1984: A report of the Joint American College of Cardiology/American Heart Association Task Force on Assessment of Cardiovascular Procedures (Sub-committee on Pacemaker Implantation). Circulation 70: 331A–339APubMedCrossRefGoogle Scholar
  2. 2.
    Dreifus LS, Fisch C, Griffin JC et al (1991) Guidelines for implantation of cardiac pacemakers and antiarrhythmia devices. A report of the American College of Cardiology/American Heart Association Task Force on Assessment of Diagnostic and Therapeutic Cardiovascular Procedures ( Committee on Pacemaker Implantation ). Circulation 84: 455–467PubMedCrossRefGoogle Scholar
  3. 3.
    Glikson M, Espinosa RE, Hayes DL (1995) Expanding indications for permanent pacemakers. Ann Intern Med 123: 443–451PubMedCrossRefGoogle Scholar
  4. 4.
    Barold SS (1996) Indications for permanent cardiac pacing in first-degree AV block: class I, II or III? PACE 19: 747–751PubMedCrossRefGoogle Scholar
  5. 5.
    Schuller H, Brandt J (1991) The pacemaker syndrome: old and new causes. Clin Cardiol 14: 336–340PubMedCrossRefGoogle Scholar
  6. 6.
    Kuniyashi R, Sosa E, Scanavacca M et al (1994) Pseudosindrome de marcapasso. Arq Bras Cardiol 62: 111–115Google Scholar
  7. 7.
    Wharton JM, Ellenbogen KA (1995) Atrioventricular conduction system disease. In: Ellenbogen KA, Kay GN, Wilkoff BL (eds) Clinical Cardiac Pacing. WB Saunders, Philadelphia, pp 304–320Google Scholar
  8. 8.
    Chirife R, Ortega DE, Salazar AL (1990) “Pacemaker syndrome” without a pacemaker. Deleterious effects of first degree AV block. RBM 12: 22Google Scholar
  9. 9.
    Mabo P, DePlace C, Gras D et al (1993) Isolated first degree AV block: an indication for permanent DDD pacing? PACE 16: 1123CrossRefGoogle Scholar
  10. 10.
    Zornosa JP, Crossley GH, Haistly WK Jr et al (1992) Pseudopacemaker syndrome: a complication of radiofrequency ablation of the AV junction. PACE 15: 590Google Scholar
  11. 11.
    Kim YH, O’Nunain S, Trouton T et al (1993) Pseudopacemaker syndrome following inadvertent fast pathway ablation for atrioventricular nodal reentrant tachycardia (1993) J Cardiovasc Electrophysiol 4: 178–182Google Scholar
  12. 12.
    Gesell RA (1911) Auricular systole and its relation to ventricular output. Am J Physiol 29: 32–63Google Scholar
  13. 13.
    Jochim K (1938) The contribution of the auricles to ventricular filling in complete heart block. Am J Physiol 122: 639–645Google Scholar
  14. 14.
    Mitchell JH, Gilmore JP, Sarnoff SI (1962) The transport function of the atrium: factors influencing the relation between mean left atrial pressure and left ventricular end diastolic pressure. Am J Cardiol 9: 237–247PubMedCrossRefGoogle Scholar
  15. 15.
    Skinner NS Jr, Mitchell JH Wallace AG et al (1963) Hemodynamic effects of altering the timing of atrial systole. Am J Physiol 205: 499–503PubMedGoogle Scholar
  16. 16.
    Nishimura RA, Hayes DL, Holmes DR et al (1995) Mechanism of hemodynamic improvement by dual-chamber pacing for sever left ventricular dysfunction: an acute doppler and catheterization hemodynamic study. J Am Call Cardiol 25: 281–288CrossRefGoogle Scholar
  17. 17.
    Ishikawa T, Kimura K, Miyazaki N et al (1992) Diastolic mitral regurgitation in patients with first degree atrioventricular block. PACE 15: 1927–1931PubMedCrossRefGoogle Scholar
  18. 18.
    Levine PA (1992) Uncommon applications for pacing therapy and minimizing reimbursement hassles Siemens-Pacesetter, SylmarGoogle Scholar
  19. 19.
    Wenckebach KF (1899) Zur Analyse des unregelmässigen Pulses. Z Klin Med 37: 475Google Scholar
  20. 20.
    Hay J (1906) Bradycardia and cardiac arrhythmia produced by depression of certain functions of the heart. Lancet 1: 139CrossRefGoogle Scholar
  21. 21.
    Mobitz W (1924) Uber die unvollstandige Storung der Erregungsuberleitung Zwischen Vorhof and Kanmer des menschlichen Herzens. Z Ges Exp Med 41: 180–237CrossRefGoogle Scholar
  22. 22.
    Ursell S, Habbab MA, El-Sherif N (1991) Atrioventricular and intraventricular conduction disorders: clinical aspects. In: El-Sherif N, Samet 0 (eds) Cardiac pacing and electrophysiology. WB Saunders Company, Philadelphia, pp 140–169Google Scholar
  23. 23.
    Donoso E, Adler LN, Friedberg CK (1964) Unusual forms of second degree atrioventricular block, including Mobitz type II block, associated with Morgagni-AdamsStokes syndrome. Am Heart J 67 (2): 150–157PubMedCrossRefGoogle Scholar
  24. 24.
    Dhingra RC, Denes P, Wu D et al (1974) The significance of second degree atrioventricular block and bundle branch block. Observations regarding site and type of block. Circulation 49: 638–646PubMedCrossRefGoogle Scholar
  25. 25.
    Strasberg B, Amat-Y-Leon F, Dhingra RC et al (1981) Natural history of chronic second degree atrioventricular nodal block. Circulation 63 (5): 1043–1049PubMedCrossRefGoogle Scholar
  26. 26.
    Clarke M, Sutton R, Ward D et al (1991) Recommendations for pacemaker prescription for symptomatic bradycardia. Report of a working party of the British Pacing and Electrophysiology Group. Br Heart J 66: 185–191CrossRefGoogle Scholar
  27. 27.
    Shaw DB, Kekwick C, Veale D et al (1985) Survival in second degree atrioventricular block. Br Heart J 53: 587–593PubMedCrossRefGoogle Scholar
  28. 28.
    Connelly DT, Steinhaus DM (1996) Mobitz type I atrioventricular block: an indication for permanent pacing? PACE 19: 261–264PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Italia 1998

Authors and Affiliations

  • L. Padeletti
    • 1
  • A. Michelucci
    • 1
  • P. Ticci
    • 1
  • P. Pieragnoli
    • 1
  1. 1.Istituto di Clinica Medica Generale e CardiologiaUniversità di FirenzeItaly

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