Table 2

Indications for temporary transvenous cardiac pacing

Acute myocardial infarction: (Class I: ACC/AHA)3
• Asystole
• Symptomatic bradycardia (sinus bradycardia with hypotension and type I 2nd degree AV block with hypotension not responsive to atropine)
• Bilateral bundle branch block (alternating BBB or RBBB with alternating LAHB/LPHB)
• New or indeterminate age bifascicular block with first degree AV block
• Mobitz type II second degree AV block
Bradycardia not associated with acute myocardial infarction
• Asystole
• 2nd or 3rd degree AV block with haemodynamic compromise or syncope at rest
• Ventricular tachyarrhythmias secondary to bradycardia
• Support for procedures that may promote bradycardia
• General anaesthesia with:
 2nd or 3rd degree AV block
 Intermittent AV block
 1st degree AV block with bifascicular block
 1st degree AV block and LBBB
• Cardiac surgery
 Aortic surgery
 Tricuspid surgery
 Ventricular septal defect closure
 Ostium primum repair
Rarely considered for coronary angioplasty (usually to right coronary artery)
Overdrive suppression of tachyarrhythmias