Av node pacemaker

If the AV node also fails, Purkinje fibers are occasionally capable of acting as the default or escape pacemaker. The reason Purkinje cells do not normally control the heart rate is that they generate action potentials at a lower frequency than the AV or SA nodes. Artificial pacemakers AV node ablation and pacemaker implantation is usually reserved for patients in whom all other treatments of atrial fibrillation have been ineffective. The first step is to implant the pacemaker. By itself the pacemaker will not improve the way you feel. However, following this a special procedure called AV Node ablation (sometimes also called. Celler runtomkring AV-noden har pacemaker-förmåga. Själva AV-nodens celler har sannolikt ingen automaticitet. Alla celler i His-Purkinjesystemet besitter automaticitet. Dessa strukturer kallas latenta pacemakers eftersom de är inaktiva under normala omständigheter

Background In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternativ.. SA node is known as the pacemaker of the heart, while AV node is also known as pace setter of the heart. SA node is the first component of conducting a system of the heart. It is a small body of specialized muscular tissue in the wall of the right atrium of the heart, whereas AV node is the second component of conducting a system of the heart En pacemaker, även kallad hjärtstimulator eller pulsgenerator [1], är en elektronisk apparat som opereras in i kroppen hos personer vars hjärtas pumpverksamhet inte alltid fungerar som den ska till följd av fel i hjärtats elektriska fortledningssystem.Exempel på indikation för hjärtstimulatorimplantation är att sinusknutan eller AV-noden inte fungerar tillfredsställande, varvid. BAKGRUNDVärldens första pacemakerimplantation utfördes 1958 vid Karolinska sjukhuset av dr Åke Senning. Idag finns det cirka 50 000 pacemakerbärare i Sverige. En konventionell pacemaker består av en batteridriven impulsgivare till vilken en eller två elektroder är anslutna. Elektroderna är placerade i höger förmak och/eller höger kammare och via dessa avkänns den egna hjärtrytmen.

Cardiac pacemaker - Wikipedi

Atrial Fibrillation: Pacemaker and AV Node Ablation

  1. Pacemaker implantation needs to be done prior to AV node ablation to keep the lower chambers (ventricles) beating properly. In some centres doctors prefer to implant pacemaker several weeks before ablation, to ensure satisfactory and stable device function
  2. This patient had a permanent pacemaker lead placed in the right ventricle (in black) two weeks earlier so that AV node ablation could be performed. This is done by passing the ablation catheter (in blue) up to the heart (through the femoral vein at the top of the leg) to cauterise the AV node and prevent any further rapid conduction of heart rates from the atria
  3. Sinoatrial (SA) Node . The sinoatrial node, also referred to as the pacemaker of the heart, coordinates heart contractions. Located in the upper wall of the right atrium, it generates nerve impulses that travel throughout the heart wall causing both atria to contract. The SA node is regulated by the autonomic nerves of the peripheral nervous system
  4. But if you get the procedure in your AV node, Pacemaker. It's a small device that monitors your heartbeat and sends out a signal to stimulate your heart if it's beating too slowly
  5. AV node ablation. In atrioventricular (AV) node ablation, doctors use radiofrequency energy to destroy the electrical connection between the upper and lower heart chambers (AV node), blocking the heart's electrical impulses. Once the AV node is destroyed, doctors then implant a small medical device to maintain a heart rhythm (pacemaker)
  6. AV node ablation, yes or no? A AV node ablation was recommended for me and I am hesitant as it is a last resort procedure. So other peoples out come is. important to me. My heart rate when resting is 84bpm both AFL and AFIB locked to each other. Looks like sinus but is not. Ablation and the Maze did not help. Age 87 but reasonably fit

AV node ablation and pacemaker insertion on June 10th. by Pacingaway - 2019-06-22 14:16:46 Hello folks, just joined this club. I had an AV ablation and CRT pacemaker inserted (pacemaker is Metronic). I have heard that the metronic pacemakers have and alert (not sure if recalled) An AV node ablation may be an option to consider for patients who already have a pacemaker or need one for other reasons. Recent Discussions From The Providers Office Forum mikeqi2011 posted Re: Providers in Southern California for ablation or mini-maze on October 16, 2020 3:43pm ES

We assess whether AV node ablation and pacemaker implantation after discontinuation of effective rate-control medical therapy for chronic atrial fibrillation had a positive impact on quality of life and exercise performance. To assess the possibility of a placebo effect following pacemaker implantat Pacemaker Sammanfattning Pacemaker är en behandling som erbjuds patienter med en alltför långsam hjärtrytm eller som bedöms löpa risk för att få det. Pacemakern övervakar hjärtats rytm och behandlar den långsamma rytmen med hjälp av pacemakerstimulering. Insättandet av en pacemaker är ett rutiningrepp som görs Utsättande av andra blodförtunnande som (NOAK) lämnas skriftlig instruktion i kallelsen om. Trombyl fortsätter du med som vanligt inför operationen. kontrollera Din pacemaker. Vill Du prata med operatören kan vi ordna det. Allmän information till dig som skall göra pacemakerbyte | Kardiologi/Område I/NU-sjukvården, 2019-09-24

Introduktion till Pacemaker, ICD och CRT - Klinisk diagnosti

AV node ablation and pacemaker implantation is usually reserved for patients in whom primary ablation may be too risky or when all other treatments to control the ventricular rate have been ineffective. Occasionally this may be suggested as an urgent strategy when there is evidence of worsening heart failure It replaces the heart's defective natural pacemaker functions. The sinoatrial (SA) node or sinus node is the heart's natural pacemaker. It's a small mass of specialized cells in the top of the right atrium (upper chamber of the heart). It produces the electrical impulses that cause your heart to beat

Long-Term Survival after Ablation of the Atrioventricular

After an AV Node Ablation with Pacemaker procedure, patients report feeling better with an improved quality of life (being able to golf 18 holes, for example) than when A-Fib made their heart race. Note: If you suffer from Sick Sinus Syndrome (a bad Sinus Node) and would need a pacemaker anyway, an AV Node ablation procedure may be appropriate Heart block that occurs within the AV node (so-called proximal heart block) is usually pretty benign and often does not require a permanent pacemaker. When the block is occurring within the AV node, subsidiary pacemaker cells in the AV node just beyond the site of the block often take over the rhythm of the heart AV node ablation An AV node ablation is performed in people who have been diagnosed with atrial fibrillation that has not responded to medication. An AV node ablation and insertion of a permanent pacemaker will regulate your heart rate and provide relief from the symptoms you have been experiencing. This procedure stop As AV node ablation and pacemaker insertion is not able to cure all patients of their symptoms of AF and some patients may choose not to have this procedure, alternatives are available: • Continuing to find a medication that is effectiv One topic, AV node ablation, makes the rounds of the atrial fibrillation discussion groups on a regular basis, and has just come back around again. All at about the same time, several afib patients' doctors have insisted that they have an AV node ablation with a pacemaker implant. Thus they have come seeking others' experiences

Difference Between SA Node and AV Node - Difference Wik

  1. The AV node will also act as a backup pacemaker in case the primary pacemaker or the SA node fails. The human heart can be compared electrically as follows: The SA node is the capacitor, the AV.
  2. R: The pacemaker is capable of rate modulation (increasing rate during periods of increased metabolic demand) O : It is not a multi-site pacemaker (it is not used for re-synchronization therapy) In practice it is common for only the first 3 letters to be used (VVI, DDD)
  3. Background: In patients with atrial fibrillation that is refractory to drug therapy, radio-frequency ablation of the atrioventricular node and implantation of a permanent pacemaker are an alternative therapeutic approach. The effect of this procedure on long-term survival is unknown. Method: We studied all patients who underwent ablation of the atrioventricular node and implantation of a.
  4. Pacemaker-dependent patients exposed to noise (e.g., electrocautery during surgery) Avoids oversensing and asystole: Pacing regardless of intrinsic events Potential risk for arrhythmia induction: Single-chamber pacing (AAI, VVI) AAI: sick sinus syndrome with intact AV node; preserves AV synchrony VVI: atrial fibrillation with slow VR and single.
  5. AV sequential pacemaker an implanted pacemaker with dual chamber pacing that maintains the atrial part of ventricular filling by stimulating the atrium if it does not respond at the proper interval after ventricular activity; used for patients with abnormal sinus node function or decreased atrioventricular conduction
  6. Objective—To assess the effect of atrioventricular node ablation and implantation of a dual chamber, mode switching pacemaker on quality of life, exercise capacity, and left ventricular systolic function in patients with drug refractory paroxysmal atrial fibrillation. Patients—18 consecutive patients with drug refractory paroxysmal atrial fibrillation
  7. Advantages of AV node ablation and pacing • AV node ablation and pacing as a treatment for AF has been practised since 1990 and so a great deal of experience and evidence from clinical trials has been gathered. • There is a very high single-procedure success rate, both for pacemaker implantation and AV node ablation
Difference Between SA node and AV node | Compare the

Atrial spike conducted through AV node and generates QRS; Wide QRS. Generated by ventricular lead stimulus; Absence of paced complexes in a patient with a pacemaker does not always indicate pacemaker dysfunction. It may reflect adequate native conduction My understanding is that long term, persistent or permanent AF is a cause of heart failure, however, a 2 lead pacemaker if you have had a AV node ablation will also lead to de synchronization of the ventricles which will lead to a 40% chance of heart failure The artificial pacemaker is one of the great medical inventions of the 20th century. Cardiac pacing has evolved from a hazardous experiment in the 1930s, to a routine, safe and sophisticated treatment used worldwide. Artificial pacemakers have benefitted immensely from advances in engineering, notably with the advent of transistors, programmable circuits, lithium batteries, and Internet.

Slide Show 9 at University of New Brunswick - StudyBlue

Pacemaker - Wikipedi

  1. The pacemaker is put in place before the AV node ablation is done. Going home Why is it done? When the heart is in atrial fibrillation (AF), the electrical signals in the upper chambers of the heart (atria) become irregular and very fast. This causes the atrial muscles to quiver (or fibrillate) instea
  2. Once the AV node is destroyed, your doctor implants a small medical device to maintain a heart rhythm (pacemaker), unless your pacemaker is already in place. You will need a pacemaker for the rest of your life. Results. AV node ablations have a high success rate
  3. Pacemaker must be considered in all these conditions, despite the low risk of asystole. The low risk of asystole is explained by the fact that (1) there are several latent pacemakers downstream of the sinus node and (2) AV conduction is not affected by sinus node dysfunction
  4. Bradyarrythmias, which are slow heart rhythms that may arise from disease in the heart's electrical conduction system (such as the SA node, AV node, or HIS-Purkinje system). Heart failure
  5. Action potential physiology phases and steps made easy. Learn depolarization and repolarization of cardiac atrial ventricular myocyte muscle cells that lead to contraction and heart pacemaker cells, including SA node, AV node, bundle of His, right and left bundle branches, and Purkinje fibers that
  6. ute. If you are exercising, doing strenuous work or you are under a lot of stress, your heart rate may be faster

Pacemaker - Internetmedici

There are actually two pacemakers. The SA node is the primary; the atrioventricular node (AV node), located in a bundle of tissues on the border between the right atrium and the right ventricle, is the secondary. When the SA node sends out an electrical impulse, the first place it goes is to the AV node To our knowledge, these are the first documented cases of simultaneous leadless pacemaker implantation and AV node ablation with a single vascular access site. We demonstrate that AV nodal ablation can safely be performed immediately after implantation of a leadless pacemaker without the need for any additional vascular access and without dislodgement of the Micra pacemaker http://www.interactive-biology.com - In this episode, I talk about how the Pacemaker Potential results in the signal that causes the heart to beat. I show ho..

Egentligen var hon för ung, men inte desto mindre berodde hennes återkommande svimningsanfall på hjärtstillestånd - som i vaket tillstånd varade upp mot en halv minut. Det visade sig att 27-åriga Johanna var i akut behov av en pacemaker. Så hur skulle det nu gå med basketkarriären? AV: Emma Samuelsson Maj 2010. Johanna Nilsson, [ FIG. 1A is a schematic diagram of a pacemaker system in accordance with this invention, illustrating positioning of leads in the right atrium and the right ventricle, and also showing the positioning of at least one electrode for delivering bursts of inhibiting pulses proximate to the AV node; FIG. 1B is a detailed diagram of the distal end of an atrial lead in accordance with this invention.

The AV node checks the signal and sends it through the muscle fibers of the lower chambers (the ventricles), causing them to contract. What is an implantable pacemaker? A pacemaker is a small device that is run by a battery. It helps the heart beat in a regular rhythm. Pacemakers can help pace the heart in cases of slow heart rate, fast and. Implantationen av pacemaker äger rum flera veckor före ablation för att säkerställa att enheten fungerar tillfredsställande och stabilt. Hjärtrytmen är e fter ablation helt beroende av pacemakern och du behöver inte ta läkemedel för att kontrollera hjärtfrekvensen. En AV-node-ablation har hög framgångsfrekvens Sometimes the primary pacemaker (SA node), becomes too slow and the AV node may have to take over the rhythm. This is known as sick sinus syndrome, and depending on the circumstances, may require an artificial pacemaker. So in summary, yes, there are two natural pacemakers the SA node and the AV node

AV node ablation and pacemaker implantation is usually reserved for patients in whom all other treatments of atrial fibrillation have been ineffective. The first step is to implant the pacemaker. By itself the pacemaker will not improve the way you feel After AV node ablation, a pacemaker is necessary as the heart rate would otherwise be very slow. At U-M, we focus on choosing the most appropriate treatment strategy for each patient, Oral says. We've found that controlling the rhythm often results in a better quality of life for our patients;. AV node ablation. In atrioventricular (AV) node ablation, doctors use radiofrequency energy to destroy the electrical connection between the upper and lower heart chambers (AV node), blocking the heart's electrical impulses.Once the AV node is destroyed, doctors then implant a small medical device to maintain a heart rhythm (pacemaker) av node ablation pacemaker. A 50-year-old member asked: What do the experts think, should my physical fatigue go away after the av node ablation procedure with pacemaker? Dr. Calvin Weisberger answered. 50 years experience Cardiology Because AV node ablation does not cure atrial fibrillation, the patient is dependent on a pacemaker for the rest of his or her life and will have to continue taking a blood thinner to prevent strokes. Complications of AV Node Ablation. There is a 1 or 2 percent risk of a complication during the pacemaker implantation procedure, including: Infectio


Att få en pacemaker - 1177 Vårdguide

So, for ablation, the answer is yes, but that must be very selective. For the bulk of the population, yes, what we're talking about is the role and whether there's increasing role for the AV node ablation and pacing. How frequent is this condition of rapid AFib that you can't easily manage with, say, beta-blockers or calcium-channel blockers More commonly, isorhythmic dissociation is present when two independent pacemakers (usually the sinus and AV nodes) beat at approximately the same rate and thereby compete for control of the cardiac rhythm. The dominant rhythm changes as one slightly slows or speeds its rate. This rhythm is commonly seen during inhalational anesthesia

Hjärtats retledningssystem - Wikipedi

with slide / Patients with refractory atrial fibrillation treated with ablation of the AV node and implantation of a pacemaker face no adverse effect on long-term survival from this approach. This is directed to A-Fibbers who have reached the point of no return and have to have or did have the AV Node ablated and a pacemaker put in. (See: Ablation or Modification of the Atrioventricular [AV] Node and Implementation of a Pacemaker) As my EP put it, this is the end, you know just prior to me having mine done AV nodal ablation and pacemaker implantation improves hemodynamic function in atrial fibrillation. Takahashi Y(1), Yoshito I, Takahashi A, Harada T, Mitsuhashi T, Shirota K, Kumagai K, Nuruki N, Shiraishi T, Nitta J, Ito H; Ablation and Pacing Therapy Working Group 2 Clinical need and practice. 2.1 Abnormal heart rhythms (dysrhythmias) are caused by disturbances in electrical impulse generation or by abnormal conduction between chambers of the heart - principally within the sinus node, atrioventricular (AV) node and the His-Purkinje network. Dysrhythmias may be fast (tachyrhythmias) or slow (bradyrhythmias), and regular or irregular

Cells within the sinoatrial (SA) node are the primary pacemaker site within the heart. These cells are characterized as having no true resting potential, but instead generate regular, spontaneous action potentials.Unlike non-pacemaker action potentials in the heart, and most other cells that elicit action potentials (e.g., nerve cells, muscle cells), the depolarizing current is carried into. The pacemaker, or sinuatrial node, regularly sends out nerve impulses which spread through the two atria, 045 The Pacemaker Potential of the SA Node and the AV Node - Duration: 5:27 AV node ablation destroys this connection stopping any atrial activity from reaching the ventricle. This results in the intrinsic pacemaker of the heart shifting from the atria to the ventricles Other articles where Sinoatrial node is discussed: mammal: Circulatory system: of specialized cells called the sinoatrial node, located in the right atrium near the junction with the venae cavae. A wave of excitation spreads from this node to the atrioventricular node, which is located in the right atrium near the base of the interatrial septum Pacemaker eller pulsgenerator (även hjärtsimulator [1]) är en elektronisk apparat som opereras in i kroppen hos personer vars hjärtas pumpverksamhet inte alltid fungerar som den ska till följd av fel i hjärtats elektriska fortledningssystem.Exempel på indikation för pacemakerimplantation är att sinusknutan eller AV-noden inte fungerar tillfredsställande, varvid patienten kan svimma.

Is AV node ablation and a biventricular pacemaker a good option for controlling afib? In my mother's case, the doctor is saying it is really the only alternative at this point, but I am concerned because of all the articles I have read warning against it for various reasons such as the permanent decision that cannot be reversed, or more so because it does not actually resolve afib and the. implanted. This is a condition where the AV node does not transmit the electrical pulse from the top to the bottom of the heart. It may be complete or partial. When this happens the heart usually beats very slowly and you may have symptoms of dizziness or blackouts. A pacemaker is required to restore a normal heart rate and bypass the 'block' This type of pacemaker is used in patients with a reliable sinus node, but with an AV-block. DDD: The pacemaker records both atrial and ventricular rates and can pace either chamber when needed. DDDR: As above, but the pacemaker has a sensor that records a demand for higher cardiac output and can adjust the heart rate accordingly Question: True Or False 28 The AV Node Is The Secondary Pacemaker Of The Heart And Can Undergo About 50 Depolarizations/min 29. The Tunica Externa Of Is Made Of Connective Tissue And Is Thicker In Veins Than In Comparable Arteries 30. Valves Help Prevent Back Flow Of Blood In Veins Of Legs 31 Av 989 patienter som erhållit Micra krävdes revision i 1,4 procent av fallen (11 revisioner; endast 25 procent av vad som krävts för historiska kontroller med transvenös pacemaker). Av dessa utfördes försök till perkutan extraktion i fem fall, varav tre lyckades; ett system kunde extraheras i samband med öppen klaffkirurgi och i sju fall kvarlämnades systemet inaktiverat [13]

Pacemaker Potential. The pacemaker potential occurs at the end of one action potential and just before the start of the next. It is the slow depolarisation of the pacemaker cells e.g. cells of the sinoatrial node, towards threshold. This is sometimes referred to as the 'funny' current, or I f Question 1 1 pts This is the heart's natural pacemaker. O AV node OSA node O AV bundle O Purkinje fibers Question 2 1 pts This valve separates the right atrium and right ventricle, O aortic O tricuspid O bicuspid/mitral O pulmonary Question 3 1 pts The heart's lub sound is made by the closing of these valves atrioventricular O semilunar Question 4 1 pts In an EKG, this is formed by the. Ø The fastest pacemaker cells establish the heart rate; the loss of the SA node means the AV node establishes heart rate (which is slower than SA node) Ø Removal of AV node can mean secondary pacemaker cells (i.e. in Purkinje fibres assume their own, slower rhythm) Ø Sometimes secondary pacemaker cells can undergo an ectopic focus whereby their autorhythmic rate becomes greater than the SA.

AV Node Ablation and Pacemaker - Support Network Hom

BAKGRUND Sinusknutan är en ca 3x10 mm stor struktur som sitter högt lateralt i högra förmaket där den övre hålvenen (vena cava superior) mynnar i förmaket. Den är rikligt innerverad av såväl det parasympatiska som sympatiska nervsystemet. I vila är hjärtat under samtidig påverkan av de bägge autonoma systemen (parasympatikus dominerande vid de flesta tillfällen). Vid [ Because the pacemaker lead doesn't lie in the sinus node or the AV node, the P waves and QRS complexes will vary from normal. Usually the wire is embedded at the bottom of the ventricle (far from the AV node) so QRS complexes are wide and bizarre. Fusion beats occur when a pacing stimulus and an intrinsic beat partly depolarize the ventricles If the SA Node fails to fire, or fires at a much slower rate, the AV node may take over as pacemaker at a rate of 40 - 60 BPM. If the AV Node fails or fires at a much slower rate, the Perkinjie fibers may act as pacemaker at a rate of 20 - 40 BPM. The ECG is a graph of the electrical activity of the heart

What Is Involved In AV Node Ablation? This is usually performed approximately 4-6 weeks after the pacemaker is implanted to ensure that the pacemaker has adequately healed and is functioning properly. Occasionally it may be performed at the same time as the pacemaker implantation Mimics normal AV nodal function by adjusting AV INSIGNIA® pacemakers) baseline QRS duration in a clinical trial of pacemaker therapy for sinus node dysfunction. Circulation. 2003;107: 2932-2937. November 30, 2009 ©2009 Boston Scientific Corporation or its affiliates After ~ 242 ms, the ventricle activates normally through the AV node-His bundle and intraventricular conduction system, resulting in a normal narrow, normal-appearing QRS complex. This rhythm could represent a single-chambered atrial pacemaker or a dual-chamber pacemaker in which the intrinsic QRS activates the ventricle without the need for ventricular pacing

Pacemaker implantation - Why it's performed - NH

Doctors give unbiased, helpful information on indications, contra-indications, benefits, and complications: Dr. Tuzcu on av node pacemaker: If what you describe occurs we call that av nodal escape rhythm. This can generally be recognized on the ecg 2 Clinical need and practice. 2.1 Abnormal heart rhythms (dysrhythmias) are caused by disturbances in electrical impulse generation or by abnormal conduction between chambers of the heart - principally within the sinus node, atrioventricular (AV) node and the His-Purkinje network. Dysrhythmias may be fast (tachyrhythmias) or slow (bradyrhythmias), and regular or irregular

Life after pacemaker and av node abla - British Heart

SA node (pacemaker) creates an ac tion potential → signal spreads across atria and causes their contraction → signal reaches AV node and is slowed down → AV node conducts the signal to bundle of His down the interventricular septum to Purkinje fibers in myocardium → they carry the signal across the ventricles → the ventricles contract (electromechanical coupling Rehabilitering efter en pacemaker. Efter implantation av en artificiell pacemaker har patienten en lång rehabiliteringsperiod. Återhämtningen tar från 2 till 8 månader. Konventionellt är denna period uppdelad i flera steg: Postoperativ vård av såret och övervakning av ECS: s arbete Ventricular (AV) node or bundle of His, an atrial pacemaker (AAI) could be placed. 2. Accompanying disease of the AV nodal conduction requires a dual-chamber (DDD or DDI) system. 3. Patients with sinus node disease, AV node disease, or lower conduction system diseas The pacemaker acts as a conduit around the AV node. There is the same risk of tracking an atrial tachy‐arrhythmia as in DDD, and the same safeguards must be in place to prevent this. A summary of the various antibradycardia pacing modes and their indications is presented in a decision‐tree approach in Figure 1 When a pacemaker is present, no AV node is necessary, so it can be knocked out, leaving the pacemaker to control the heart rate in the ventricles. This procedure is irreversible and will make you dependent on your pacemaker. Nonetheless, it is highly effective for symptom treatment,.

How Does the Heart Work? | AED Superstore Resource Center

Overview of the Atrioventricular Node (AV Node

Asymptomatic type I second-degree AV block at the supra-His (AV node) level or not known to be intra- or infra-Hisian. AV block expected to resolve and/or unlikely to recur (e.g., drug toxicity, Lyme disease, or during hypoxia in sleep apnea syndrome in absence of symptoms). Adapted from ACC/AHA/NASPE Guidelines for Pacing, 2002 (2) A pacemaker is inserted and the AV node is ablated leaving the patient dependent on the paced rhythm. This alleviates the vast majority of palpitation symptoms patients feel but does mean that the patient will require a pacemaker for the rest of their life

pacemaker-info.se Här kan du som har eller ska få pacemaker och dina anhöriga läsa allt om pacemakerbehandling Du finner också ett antal fördjupningar i hjärtats funktion oc Under normal circumstances, each beat starts in the natural pacemaker called sinus node in the right atrium. The impulse then spreads across the top chambers and down via a junction called atrioventricular or AV node which lies between atria and ventricles The first three of the underlying causes that warrant PPM are a conduction abnormality that can be located above the AV node, at the AV node, or below the AV node. Arrhythmias caused by conduction issues originating below the AV node, i.e. the His-Purkinje system, are more likely to worsen than those within the AV node; thus rhythms pointing towards the former location will benefit from PPM.

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