Managing second-degree atrioventricular block (Mobitz Type 2) is shaped by the patient's underlying rhythm. When permanent atrial fibrillation is present, the coexisting conduction failure and the absence of organised atrial activity together define a distinct clinical picture that calls for a specific, guideline-directed approach.
This protocol applies to patients with second-degree AV block (Mobitz Type 2) who have permanent atrial fibrillation. The presence of permanent AF is the key comorbidity that directs both the indication for intervention and the choice of pacing strategy.
Guideline-directed care for this scenario centres on permanent pacemaker implantation. The recommended pacing mode and rate-responsive configuration specific to patients in permanent AF are detailed in the full protocol. Complete specification available via the link below.
DOI: 10.1093/eurheartj/ehab364
In patients with permanent AF in need of a pacemaker, ventricular pacing with rate response function is recommended.
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