Pacemaker Device And Mode Selection
Publication Date: August 1, 2012
Last Updated: March 14, 2022
Consensus Recommendations
Sinus Node Dysfunction
Dual-chamber pacing (DDD) or single-chamber atrial pacing (AAI) is recommended over single-chamber ventricular pacing (VVI) in patients with SND and intact AV conduction. (A, I)
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Dual-chamber pacing is recommended over single-chamber atrial pacing in patients with SND. (B, I)
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Rate adaptive pacing can be useful in patients with significant symptomatic chronotropic incompetence and its need should be reevaluated during follow-up. (C, IIa)
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In patients with SND and intact AV conduction, programming dual-chamber pacemakers to minimize ventricular pacing can be useful for prevention of atrial fibrillation (AF). (B, IIa)
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AAI pacing may be considered in selected patients with normal AV and ventricular conduction. (B, IIb)
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Single-chamber VVI pacing may be considered in instances where frequent pacing is not expected or the patient has significant comorbidities that are likely to influence survival and clinical outcomes. (C, IIb)
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Dual-chamber pacing or single-chamber atrial pacing should not be used in patients in permanent or longstanding persistent AF in whom efforts to restore or maintain sinus rhythm are not planned. (C, III (no benefit))
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Title
Pacemaker Device and Mode Selection
Authoring Organizations
American College of Cardiology