Parameters:
(1) type of conduction defect
(2) heart rate in beats per minute
(3) H-V interval (time from the proximal His bundle to the ventricular myocardium)
(4) symptoms (syncope, near syncope)
Types of conduction defects:
(1) left bundle branch block
(2) right bundle branch block
(3) intraventricular conduction defect
(4) right bundle branch block and left anterior hemiblock
(5) right bundle branch block and right posterior hemiblock
(6) alternating bundle branch block
(7) block below His bundle
Indications for cardiac pacing:
(1) all types of conduction defects AND H-V interval >= 100 milliseconds
(2) block below His bundle AND heart rate < 150 beats per minute
(3) alternating bundle branch block
(4) other forms of conduction defect (types 1 to 5) AND H-V interval 56 - 99 milliseconds AND symptomatic
(5) block below His bundle AND heart rate >= 150 beats per minute AND H-V interval 56 - 99 milliseconds AND symptomatic
Possible indications for cardiac pacing:
(6) other forms of conduction defect (types 1 to 5) AND H-V interval <= 55 milliseconds AND recurrent syncope AND all other causes excluded
(7) block below His bundle AND heart rate >= 150 beats per minute AND H-V interval <= 55 milliseconds AND recurrent syncope AND all other causes excluded
If the patient also has a ventricular tachycardia, then an ICD with dual chamber pacing should be considered.
