What are indicators that a patient may require conduction system pacing?

A patient may require conduction system pacing when there are persistent symptoms of bradycardia accompanied by documented AV block. This condition indicates that the electrical signals in the heart are not being conducted properly between the atria and ventricles, leading to a slower heart rate (bradycardia) and potentially causing symptoms such as fatigue, dizziness, or syncope. The presence of AV block is critical because it shows a significant disruption in the conduction pathways, which might require intervention to restore a normal heart rhythm and improve the patient's quality of life.

In this scenario, pacing the conduction system can effectively manage the problem by either providing a reliable electrical impulse to stimulate the heart or addressing the specific conduction deficit. While infrequent palpitations, fast heart rates, and confusion or dizziness may indicate cardiovascular issues, they do not possess the same direct link to the need for pacing as the combination of persistent bradycardia symptoms with documented AV block does. Thus, it is important to focus on the documented disturbances in conduction as the primary indicator for jumping into a pacing strategy.