Document Detail


DDD versus VVIR pacing in patients, ages 70 and over, with complete heart block.
MedLine Citation:
PMID:  20015129     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Dual-chamber pacing is believed to have an advantage over single-chamber ventricular pacing. The aim of the study was to determine whether elderly patients with implanted pacemaker for complete atrioventricular block gain significant benefit from dual-chamber (DDD) compared with single-chamber ventricular demand (VVIR). METHODS: The study was designed as a double-blind randomized two-period crossover study-each pacing mode was maintained for 3 months. Thirty patients (eight men, mean age 76.5 +/- 4.3 years) with implanted PM were submitted to a standard protocol, which included an interview, functional class assessment, quality of life (QoL) questionnaires, 6-minute walk test, and transthoracic echocardiographic examinations. QoL was measured by the SF-36. All these parameters were obtained on DDD mode pacing and VVIR mode pacing. Paired data were compared. RESULTS: QoL was significantly different between the two groups and showed the best values in DDD. Overall, no patient preferred VVIR mode, 18 preferred DDD mode, and 12 expressed no preference. No differences in mean walking distances were observed between patients with single-chamber and dual-chamber pacing. VVI pacing elicited marked decrease in left ventricle ejection fraction and significant enlargement of the left atrium. DDD pacing resulted in significant increase of the peak systolic velocities in lateral mitral annulus and septal mitral annulus. Early diastolic velocities on both sides of mitral annulus did not change. CONCLUSION: In active elderly patients with complete heart block, DDD pacing is associated with improved quality of life and systolic ventricular function compared with VVI pacing.
Authors:
Sana Ouali; Elyes Neffeti; Karima Ghoul; Sami Hammas; Slim Kacem; Rim Gribaa; Fahmi Remedi; Essia Boughzela
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial     Date:  2009-12-10
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  33     ISSN:  1540-8159     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-06-15     Completed Date:  2010-09-27     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  583-9     Citation Subset:  IM    
Affiliation:
Department of Cardiology, Sahloul Hospital, Sousse, Tunisia. sanaouali@hotmail.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Cardiac Pacing, Artificial / methods*
Cross-Over Studies
Female
Heart Block / therapy*,  ultrasonography
Humans
Male
Pacemaker, Artificial*
Prospective Studies
Quality of Life
Walking

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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