What is the treatment of choice for complete heart block with repeated pauses?

Transvenous cardiac pacing is the treatment of choice for complete heart block with repeated pauses because it provides reliable and direct stimulation of the heart when the intrinsic conduction system is unable to maintain an adequate heart rate. In complete heart block, there is a failure of electrical signals to be transmitted from the atria to the ventricles, which can result in significant pauses in heart rhythm leading to symptoms like dizziness, fatigue, or even loss of consciousness.

Transvenous pacing involves placing a pacing wire directly into the heart via a vein, allowing for precise control over the heart rate and rhythm. This method is particularly useful in an acute setting, providing a stable and effective way to restore adequate cardiac output until the underlying cause of the heart block can be addressed.

Other options would not adequately address the immediate need for heart rate support in this situation. For example, transcutaneous pacing might not be effective enough in cases of complete heart block with significant pauses due to comfort issues and the potential for insufficient pacing capture. Adenosine is utilized primarily for certain types of tachycardia and would not be appropriate for a heart block scenario. Defibrillation is indicated for life-threatening arrhythmias such as ventricular fibrillation or pulseless ventricular tachycardia,