The decision to install a pacemaker in second-degree type II block depends on the specific clinical presentation of the patient, and a pacemaker is recommended if accompanied by symptoms such as a significantly slow ventricular rate.
Patients with second-degree type II AV block may have intermittent beat-to-beat deregulation, but the intensity of the first heart sound is constant. Some patients may have symptoms of palpitations or may be asymptomatic. Atrioventricular block can lead to insufficient blood supply to the brain due to the slow ventricular rate, and patients may experience temporary loss of consciousness or even convulsions due to cerebral ischemia, which is called Adams-Stokes syndrome, or even sudden death in severe cases.
Patients with second-degree type II block who are asymptomatic can be temporarily selected for close clinical observation. If there are obvious symptoms or hemodynamic disorders, accompanied by a significantly slow ventricular rate, or even the occurrence of Adams-Stokes syndrome, it is recommended that pacemaker implantation be selected for treatment, and it is recommended that the patient go to the hospital and be reasonably diagnosed under the guidance of a professional physician.