Class I
(1) Permanent pacemaker implantation is indicated for sinus node
dysfunction with documented symptomatic bradycardia, including
frequent sinus pauses that produce symptoms.
(2) Permanent pacemaker implantation is indicated for symptomatic
chronotropic incompetence.
(3) Permanent pacemaker implantation is indicated for symptomatic
sinus bradycardia that results from required drug therapy for
medical conditions.
Class IIa
(1) Permanent pacemaker implantation is reasonable for SND with heart rate less than 40 bpm when a clear association between significant symptoms consistent with bradycardia and the actual presence of bradycardia has not been documented.
(2) Permanent pacemaker implantation is reasonable for syncope of
unexplained origin when clinically significant abnormalities of sinus node function are discovered or provoked in electrophysiological studies.
Class IIb
(1) Permanent pacemaker implantation may be considered in
minimally symptomatic patients with chronic heart rate less than 40 bpm while awake.
Class III
(1) Permanent pacemaker implantation is not indicated for SND in asymptomatic patients.
- (2) Permanent pacemaker implantation is not indicated for SND in patients for whom the symptoms suggestive of bradycardia have been clearly documented to occur in the absence of bradycardia.
(3) Permanent pacemaker implantation is not indicated for SND with symptomatic bradycardia due to nonessential drug therapy.