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Complete Heart Block in a Patient Declining Pacemaker Implantation: A Discussion on Patient-Centered Care and Shared
Robert W Buntyn1, Vraj Patel1, Hope N Lewis2
1Internal Medicine, Wright State University Boonshoft School of Medicine, Dayton, USA.
Patients with irreversible complete heart block (CHB) or high-risk second-degree type II atrioventricular (AV) block require permanent pacemaker (PPM) implantation. This case highlights the unexpected progression to CHB and patient autonomy challenges.
Area of Science:
- Cardiology
- Electrophysiology
- Medical Ethics
Background:
- Permanent pacemaker (PPM) implantation is standard for irreversible complete heart block (CHB) and high-risk second-degree type II atrioventricular (AV) block.
- First-degree AV block and second-degree type I AV block typically do not necessitate PPM implantation unless under specific circumstances.
- Second-degree type II AV block carries a significant risk of progressing to CHB, unlike lower-grade AV blocks.
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