Atrioventricular block, third degree
ICD-10 I44.2 · ICD-11 BC63.2

Treatment of Third-Degree Atrioventricular Block in Patients with Atrial Fibrillation

This protocol addresses the management of third-degree (complete) AV block occurring in the context of atrial arrhythmia — primarily atrial fibrillation, including permanent AF — where the block is not caused by transient, correctable factors.

Clinical Scenario

Third-degree atrioventricular block in a patient with atrial arrhythmia (mainly atrial fibrillation), including permanent atrial fibrillation; not due to transient causes that can be corrected and prevented. Pacing is indicated regardless of symptoms in this population.

Approach

The primary intervention involves cardiac pacing. The specific pacing modality is guided by the presence and pattern of atrial fibrillation.

The full structured regimen — including the recommended pacing strategy for permanent AF and related technical considerations — is available in the complete protocol.

Instant Access to Structured Evidence-Based Regimens

References

DOI: 10.1093/eurheartj/ehab364

Pacing is indicated in patients with atrial arrhythmia (mainly AF) and permanent or paroxysmal third- or high-degree AVB irrespective of symptoms.

In patients with permanent AF in need of a pacemaker, ventricular pacing with rate response function is recommended.

Pacing is not recommended in patients with AVB due to transient causes that can be corrected and prevented.

View source ↗