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Europace Advance Access published online on August 4, 2006
Europace, doi:10.1093/europace/eul091
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© The European Society of Cardiology 2006. All rights reserved
Received September 19, 2005
Accepted May 16, 2006

Article

Retrospective analysis of mode survival, reliability of atrial sensing and incidence of atrial tachyarrhythmias in 307 single-lead VDD pacemaker patients

Igor Zupan 1 *, Luka Lipar 1, David Zizek 1, Wim Boute 2, Masa Vidmar 3, Tone Gabrijelcic 4, Peter Rakovec 1, and Ales Brecelj 4

1 Department of Cardiology, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia
2 Vitatron B.V., Meander 1051, 6825 MJ Arnhem, The Netherlands
3 Educational Research Institute, Gerbiceva 62, 1000 Ljubljana, Slovenia
4 Department of Cardiovascular Surgery, University Medical Centre Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia

* To whom correspondence should be addressed.
Igor Zupan, E-mail: igor.zupan{at}mf.uni-lj.si


  Abstract

Aims The aim of this retrospective analysis was to investigate VDD mode survival, development of atrial tachyarrhythmias (AT), and long-term atrial sensing performance of VDD pacing systems.

Methods and results We implanted single-lead VDD pacemakers in patients with isolated atrioventricular block and performed a retrospective analysis of 307 patients who had their devices implanted between May 1994 and September 2001. In 39 patients (12.7%), the pacing mode had to be reprogrammed to a single-chamber ventricular pacing mode, mostly due to permanent AT. In 16 of these patients, the atrial sensing safety margin was less than 150%. The atrial sensing safety margin was insufficient, i.e. less than 100% in only seven patients. Although only 12 (3.9%) of the patients had a history of paroxysmal AT at the time of pacemaker implantation, 200 (65%) patients presented with AT during follow-up. The mean AT burden at the last follow-up was 2.5%.

Conclusion These data illustrate that single-lead VDD pacemakers can be applied without serious complications in a highly selected group of patients. Our main concern is the development of AT in a large part of our population. Over a 10-year period, two thirds of our patients presented with AT.

Keywords: Single-lead VDD pacemaker; Long-term follow-up; Atrial tachyarrhythmia; Mode survival; Retrospective analysis.
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