Document Detail

Atrial demand pacing in patients with symptomatic sick sinus syndrome.
MedLine Citation:
PMID:  7830327     Owner:  NLM     Status:  MEDLINE    
Atrial demand pacing provides a physiological, simply implemented, and less costly alternative of cardiac stimulation in symptomatic sick sinus syndrome (SSS) patients. Hindrance from widespread use stems mainly from the potential development of high degree AV block and persistent atrial fibrillation. A reappraisal of atrial pacing is now justified as we gain more clinical information. In this study we examined retrospectively the clinical course of 22 well-selected SSS patients paced in AAI mode for 30 +/- 29 months. Two patients had infrequent short-run atrial tachyrhythmia before implantation. There was an early lead dislodgement which required repositioning later. Three acute threshold increments were noted which necessitated a change in atrial pacing site in one and short-term steroid use in the other two. No other sensing, pacing or operative complication occurred and all pacing systems performed well. AII patients survived during follow-up and no patient developed congestive heart failure, though depressed left ventricular function was found in three preoperatively. No high degree AV block was encountered. Four patients presented paroxysmal atrial fibrillation (PAF) 25 +/- 16 months after the procedure, of whom one developed chronic atrial fibrillation. No single factor predicted the development of PAF. Resumption of normal pacemaker function always occurred immediately in the pause following cessation of PAF and no revision of pacing mode was required in the patient with chronic AF. Symptomatic relief was obtained in all patients. In summary, single chamber, single rate atrial pacing remains a physiologic, reliable, economic and easily implemented pacing modality affordable to a number of sick sinus patients.(ABSTRACT TRUNCATED AT 250 WORDS)
W L Lee; C W Kong; J J Wang; W L Chen; S P Wang; M S Chang
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Japanese heart journal     Volume:  35     ISSN:  0021-4868     ISO Abbreviation:  Jpn Heart J     Publication Date:  1994 Sep 
Date Detail:
Created Date:  1995-02-22     Completed Date:  1995-02-22     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0401175     Medline TA:  Jpn Heart J     Country:  JAPAN    
Other Details:
Languages:  eng     Pagination:  625-33     Citation Subset:  IM    
Department of Medicine, Veterans General Hospital, Taipei, Taiwan, Republic of China.
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MeSH Terms
Cardiac Pacing, Artificial*
Electrocardiography, Ambulatory
Follow-Up Studies
Heart Atria
Middle Aged
Sick Sinus Syndrome / physiopathology,  therapy*

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