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Indications for pacing in the treatment of bradyarrhythmias. Report of an independent study group.

Publication ,  Journal Article
Phibbs, B; Friedman, HS; Graboys, TB; Lown, B; Marriott, HJ; Nelson, WP; Preston, T
Published in: JAMA
September 14, 1984

Indications for permanent pacing in the bradyarrhythmias are summarized. In the absence of symptoms, pacing is justified only when Mobitz type II block or complete atrioventricular (AV) block is localized in the bundle-branch system. All other abnormalities of impulse generation or conduction (incomplete AV block of any type, atrial fibrillation with slow ventricular response, or sinus node dysfunction) must be shown to be stable and intrinsic and to cause CNS symptoms or hemodynamic compromise to justify pacing. Isolated intra-Hisian abnormality without failure of AV conduction is benign. Measurement of HV interval does not contribute significant information. Correlation of carotid sinus sensitivity with carotid sinus syncope is poor (5%). Bradyarrhythmia produced by minimal effective doses of an essential drug is a rare indication for pacing and requires special documentation. Inadequate indications, sources of error, and misconceptions are discussed. Generally, it is important to exclude drug effect, transient clinical states, and correctable systemic disease as causes of the abnormality before making a conclusion about pacing.

Duke Scholars

Published In

JAMA

ISSN

0098-7484

Publication Date

September 14, 1984

Volume

252

Issue

10

Start / End Page

1307 / 1311

Location

United States

Related Subject Headings

  • Syncope
  • Sick Sinus Syndrome
  • Pacemaker, Artificial
  • Myocardial Infarction
  • Humans
  • Heart Rate
  • Heart Conduction System
  • Heart Block
  • General & Internal Medicine
  • Electrophysiology
 

Citation

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Chicago
ICMJE
MLA
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Phibbs, B., Friedman, H. S., Graboys, T. B., Lown, B., Marriott, H. J., Nelson, W. P., & Preston, T. (1984). Indications for pacing in the treatment of bradyarrhythmias. Report of an independent study group. JAMA, 252(10), 1307–1311.
Phibbs, B., H. S. Friedman, T. B. Graboys, B. Lown, H. J. Marriott, W. P. Nelson, and T. Preston. “Indications for pacing in the treatment of bradyarrhythmias. Report of an independent study group.JAMA 252, no. 10 (September 14, 1984): 1307–11.
Phibbs B, Friedman HS, Graboys TB, Lown B, Marriott HJ, Nelson WP, et al. Indications for pacing in the treatment of bradyarrhythmias. Report of an independent study group. JAMA. 1984 Sep 14;252(10):1307–11.
Phibbs, B., et al. “Indications for pacing in the treatment of bradyarrhythmias. Report of an independent study group.JAMA, vol. 252, no. 10, Sept. 1984, pp. 1307–11.
Phibbs B, Friedman HS, Graboys TB, Lown B, Marriott HJ, Nelson WP, Preston T. Indications for pacing in the treatment of bradyarrhythmias. Report of an independent study group. JAMA. 1984 Sep 14;252(10):1307–1311.
Journal cover image

Published In

JAMA

ISSN

0098-7484

Publication Date

September 14, 1984

Volume

252

Issue

10

Start / End Page

1307 / 1311

Location

United States

Related Subject Headings

  • Syncope
  • Sick Sinus Syndrome
  • Pacemaker, Artificial
  • Myocardial Infarction
  • Humans
  • Heart Rate
  • Heart Conduction System
  • Heart Block
  • General & Internal Medicine
  • Electrophysiology