Atrial pacing and the risk for AV block: is there a time for change in attitude?

A literature survey was performed to establish the prevalence of second and third degree AV block among patients with permanent atrial pacemakers because of sinus node disease. This study reviews data from 28 different studies on atrial pacing with a median follow-up of 36 months. The collected data shows a median annual incidence of second and third degree AV block of 0.6%, range 0%-4.5% with a total prevalence of 2.1%, range 0%-11.9%. There was no significant difference in follow-up time between studies that showed a low, compared with a high incidence of AV-block. Patients with sinus node disease treated with atrial pacing have a low risk of developing clinically important conduction disturbances.