History of Presenting Illness Physical Examination Basic Investigation Management Diagnosis Treatment Prognosis & Evidence-Based Info Summary Questions

The patient DOES need a pacemaker as definite sinus node dysfunction is seen and the patient has definite symptoms related to the bradycardia.

The Canadian Trial of Physiologic Pacing Investigators, a randomized controlled trial conducted in 2000, determined that for the prevention of stroke and death due to cardiovascular causes physiologic pacing (dual chamber AV sequential) provides little benefit over ventricular pacing.

P=0.26

However, the rate of atrial fibrillation was significantly lower among patients in the physiologic pacing group.


P=0.0093

Graphs modified from Kerr CR, et al. Canadian Trial of Physiological Pacing: Effects of physiological pacing during long-term follow-up.