What pacing method is used in a patient with both SA node failure and complete AV node block?

What pacing method is used in a patient with both SA node failure and complete AV node block?

• A. Atrial pacing
• B. AV sequential pacing
• C. Ventricular pacing
• D. P wave triggered pacing

Answer: (B)

In a patient experiencing both SA node failure and complete AV node block, the most appropriate pacing method is AV sequential pacing. This technique involves pacing both the atria and ventricles in a synchronized manner, ensuring that the atrial contraction occurs prior to ventricular contraction. Such an approach helps to maintain an effective and coordinated cardiac output, which would otherwise be compromised due to the absence of inherent atrial depolarization and the inability of the AV node to conduct impulses from the atria to the ventricles.

In this scenario, simply pacing the atria (atrial pacing) might not be adequate, as the ventricles would still lack appropriate timing for their contraction, potentially leading to inefficient heart function. Ventricular pacing alone could lead to a loss of the coordinated relationship between atrial and ventricular contraction, which could further deteriorate cardiac efficiency and hemodynamics.

P wave triggered pacing focuses on ensuring that the pacing is aligned with intrinsic atrial activity, which is not present when both the SA node and AV node are dysfunctional. Thus, AV sequential pacing is the most effective approach, as it accommodates the need for both atrial and ventricular pacing, ensuring synchronized contractions and optimal cardiac function.