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Europace Advance Access originally published online on January 16, 2008
Europace 2008 10(2):134-137; doi:10.1093/europace/eum290
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Published on behalf of the European Society of Cardiology. All rights reserved. © The Author 2008. For permissions please email: journals.permissions@oxfordjournals.org
The online version of this article has been published under an open access model. Users are entitled to use, reproduce, disseminate, or display the open access version of this article for non-commercial purposes provided that the original authorship is properly and fully attributed; the Journal, Learned Society and Oxford University Press are attributed as the original place of publication with correct citation details given; if an article is subsequently reproduced or disseminated not in its entirety but only in part or as a derivative work this must be clearly indicated. For commercial re-use, please contact journals.permissions©oxfordjournals.org.

PACING

Long-term reliability of AAI mode pacing in patients with sinus node dysfunction and low Wenckebach block rate

Masamitsu Adachi1, Osamu Igawa1,*, Akio Yano1, Junichiro Miake1, Yoshiaki Inoue1, Kazuyoshi Ogura1, Masaru Kato1, Kazuhiko Iitsuka1 and Ichiro Hisatome2

1 Department of Cardiovascular Medicine, Tottori University Hospital, 36-1 Nishimachi, Yonago 683-8504, Japan; 2 Division of Regenerative Medicine and Therapeutics, Department of Genetic Medicine and Regenerative Therapeutics, Institute of Regenerative Medicine and Biofunction, Tottori University Graduate School of Medical Science, Yonago, 683-8504, Japan

Aims: To compare the risk of atrioventricular (AV) conduction disturbance between patients with sinus node dysfunction on AAI pacing who had a low or high Wenckebach block rate (WBR).

Methods and results: Patients with sinus node dysfunction and normal AV conduction those underwent an electrophysiological study were studied. The patients were classified into two groups: Group L was with the patients with a WBR of 100 to 129 per minute and Group H was with the patients with a WBR ≥ 130 per minute. All patients followed up every 3–6 months after an AAI pacemaker implantation. A total of 102 patients, including 35 Group L and 67 Group H, were followed for 90 ± 44 months. Six patients died from non-cardiac cause and five patients required a new atrial lead implantation due to lead failure during follow-up. Symptomatic bradycardia requiring a new ventricular lead implantation developed in four patients (annual incidence 0.5%). In Group L, two patients developed AV block (annual incidence 0.7%). In Group H, two patients developed bradycardic atrial fibrillation (annual incidence 0.4%). Kaplan–Meier analysis revealed no significant difference between the two groups (P = 0.2983).

Conclusion: These results suggest that a long-term risk of developing AV conduction disturbance is low even in patients with a WBR of 100 to 129 per minute.

Key Words: Sinus node dysfunction, Atrial pacing, Atrioventricular block, Atrial fibrillation, Pacemaker, Wenckebach block

* Corresponding author. Tel: +81 859 386517; fax: +81 859 386519. E-mail address: oigawa{at}grape.med.tottori-u.ac.jp

Manuscript submitted 12 October 2007. Accepted after revision 11 December 2007.


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