Dual-chamber pacemakers for symptomatic bradycardia due to sick sinus syndrome and/or atrioventricular block
This is an extract from the guidance and may be misleading if read alone. The complete guidance is available at guidance.nice.org.uk/ta88
1 Guidance
This guidance refers only to pacing for the primary indications of sick sinus syndrome and/or atrioventricular block, and does not cover more complex pacing indications.
1.1 Dual-chamber pacing is recommended for the management of symptomatic bradycardia due to sick sinus syndrome, atrioventricular block, or a combination of sick sinus syndrome and atrioventricular block, except:
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in the management of sick sinus syndrome in patients in whom, after full evaluation, there is no evidence of impaired atrioventricular conduction; in this situation, single-chamber atrial pacing is appropriate
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in the management of atrioventricular block in patients with continuous atrial fibrillation; in this situation, single-chamber ventricular pacing is appropriate
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in the management of atrioventricular block (atrioventricular block alone, or in combination with sick sinus syndrome), when patient-specific factors, such as frailty or the presence of comorbidities, influence the balance of risks and benefits in favour of single-chamber ventricular pacing.