Atrioventricular block

Patients with asymptomatic AV block not requiring permanent pacemaker implantation (i.e., asymptomatic first-degree AV block or type I second-degree AV block) can be followed expectantly for the development of symptoms such as syncope, episodic presyncope, exertional dyspnea or fatigue, or CHF. Repeat ECG recordings can be obtained if symptoms occur. These patients, especially in the setting of a narrow QRS interval, are at low risk for progressing to more advanced degrees of AV block.

Patients with symptomatic, irreversible AV block or irreversible advanced AV block should be considered for permanent pacemaker implantation. Patients who undergo permanent pacemaker implantation should have routine follow-up and monitoring in a device clinic.