Criteria to Pacemaker Implant

pp 333-340

Abstract

Background

Prior to permanent pacemaker implant, it is necessary to evaluate the patient's physical and mental status, the absence of associated disease that could limit life quality or duration. It is also important to define if low heart rate may worsen the underlying pathology, by increasing ventricular enlargement, or if it is necessary to use potentially conduction or ventricular automaticity depressing drugs, without neglecting the patient's and relatives' wishes. The limitation of their activities which the patients impose to themselves, is usually the factor that allows the decrease or abolition of symptoms. The"symptomatic bradicardia" comprises -all the transient brain ischaemic manifestations or general symptoms such as marked intolerance to effort or congestive heart failure.

Conclusions

The pacemaker implantation indications are divided into three classes: Class I: includes all the patients in whom a permanent pacemaker must be implanted. Class II: includes several judgements as to whether the implant must be performed or not, although in the end the procedure is generally performed. Class III: the general consensus is that the pacemaker is unnecessary.