© 2002 by European Society of Cardiology
REGULAR ARTICLES
Pre-implant determinants of adequate long-term function of single lead VDD pacemakers
Cardiovascular Laboratory, Division of Cardiology, Helsinki University Central Hospital Helsinki, Finland
Manuscript submitted 20 March 2001. Accepted after revision 13 January 2002.
Correspondence: Sami Pakarinen, MD, Division of Cardiology, Helsinki University Central Hospital, P.O. Box 340, Haartmaninkatu 4, FI-00290 Helsinki, Finland. E-mail: sami.pakarinen{at}hus.fi
Key Words: Single lead VDD pacing, heart block, atrioventricular block, sinus node dysfunction, atrial fibrillation, prediction
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Aims |
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 Top Aims Methods and resultsConclusionsReferences |
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An inherent limitation of single lead VDD pacing is the inability to stimulate the atria. Reprogramming and upgrading the pacemaker system may be required when sinus node dysfunction, atrial undersensing, or atrial fibrillation develop. We evaluated whether routine clinical information is sufficient to select patients to benefit in long-term from VDD pacing.
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Methods and results |
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TopAimsMethods and resultsConclusionsReferences |
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We collected data on 12-lead and monitored electrocardiograms and routine clinical information at implantation of a VDD pacing system in 350 consecutive patients with grade II or III atrioventricular conduction block. The age at implantation was 74·5±8·0 years, and the follow-up lasted 1·5±1·5 years. The cumulative maintenance of VDD pacing mode was 91·4%. Loss of VDD mode was due to permanent atrial fibrillation in 16 (4·6%), sinus node dysfunction in six (1·7%), atrial undersensing in 11 (3·1%). Chronic atrial fibrillation developed in 23% of patients who had heart enlargement in chest x-ray and a history of paroxysmal atrial fibrillation or flutter. A criterion of normal sinus rate at implantation sufficiently predicted adequate sinus node function. Poor atrial sensing was not predicted by pre-implant characteristics.
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Conclusions |
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TopAimsMethods and resultsConclusionsReferences |
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According to our data, adequate sinus-driven atrial rate and no history of paroxysmal atrial fibrillation and cardiac enlargement predict maintenance of the VDD pacing mode in elderly patients treated for heart block. Routine information available at implantation is sufficient to guide acceptance of single lead VDD pacing therapy.Copyright 2002 The European Society of Cardiology. Published by Elsevier Science Ltd. All rights reserved .
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References |
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