What are the indications for a permanent pacemaker ? • Symptomatic bradyarrhythmias (heart rate <40 beats/min or documented periods of asystole >30 seconds when awake). Symptoms include syncope, pre-syncope, confusion, seizures, or congestive heart failure and they must be clearly related to the bradycardia. • Asymptomatic Mobitz type I1 atrioventricular block (N Engl d Med 1998; 338: 1147-8). • Complete heart block.
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