Bradycardia - dual chamber pacemakers (TA88)
Dual-chamber pacemakers for symptomatic bradycardia due to sick sinus syndrome and/or atrioventricular block
Dual-chamber pacemakers are recommended to treat symptomatic bradycardia in people with sick sinus syndrome, atrioventricular block, or both. But there are a number of special circumstances where dual-chamber pacemakers should not be used for symptomatic bradycardia.
The first of these circumstances is when the symptomatic bradycardia is caused by sick sinus syndrome, but the flow of electrical impulses between the upper and lower chambers of the patient's heart is normal. When this happens, a single-chamber pacemaker should be used. When the pacemaker is fitted to these patients, it should be attached to the upper chamber of the heart.
The second is when the symptomatic bradycardia is caused by atrioventricular block and the patient has continuous atrial fibrillation (this is a rapid and irregular beating of the upper chamber of the heart). When this happens a single-chamber pacemaker should be used, and it should be attached to the lower chamber of the heart.
Doctors should consider the risks and benefits of using a dual-chamber pacemaker for individual patients. Patients may be frail or have other medical conditions that may make a dual-chamber pacemaker unsuitable for them. For these patients, a single-chamber pacemaker should be used, and should be attached to the lower chamber of the heart.
- TA88 Bradycardia - dual chamber pacemakers: review decision - December 2012
- TA88 Bradycardia - dual chamber pacemakers: review proposal - August 2012
- Bradycardia - dual chamber pacemakers: review proposal - September 2011
- Review update - June 2010
- TA88 Bradycardia - dual chamber pacemakers: review decision
- Review proposal
- NICE issues guidance on the use of dual-chamber pacemakers for symptomatic bradycardia
- Assessment report for appraisal of dual chamber pacing
- TA88 Bradycardia - dual chamber pacemakers: distribution list
This page was last updated: 27 November 2012
- Web format
- Quick reference guide (PDF)
- Full Guidance (PDF)
- TA88 Rheolyddion calon dwy siambr ar gyfer trin bradycardia symptomatig: deall canllawiau NICE
Information for the public
Implementation tools and resources
- None available
See this guidance in practice
The summary of the key recommendations in the guidance written for patients, carers and those with little medical knowledge and may be used in local patient information leaflets.
Quick Reference Guide
The quick reference guide presents recommendations for health professionals
The published NICE clinical guidance, contains the recommendations for health professionals and NHS bodies.
The published full clinical guidance for specialists with background, evidence, recommendations and methods used.