| Long-term outcome of atrial synchronous mode pacing in patients with atrioventricular block using a single lead. | |
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MedLine Citation:
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PMID: 20063297 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
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BACKGROUND: Current guidelines suggest the use of atrial synchronous mode (VDD) pacemakers in patients with atrioventricular (AV) block and normal sinus node function. However VDD mode is being used much less than expected. The objectives of our study were to evaluate the efficacy of VDD pacing in long-term follow-up and to find risk factors for VDD loss. METHODS: We retrospectively evaluated all patients with VDD pacemakers who were implanted in our center between 1995 and 2007. RESULTS: During the study period, 123 consecutive patients with AV block (51% men, age 62 +/- 17.8 years) received a VDD pacemaker. Mean follow up duration was 4.5 +/- 3.2 years. At the last follow up visit, 21 patients (21.6%) lost their original VDD mode and were programmed to ventricular-based pacing (VVIR) (undersensing, 11; chronic AF, 7; SND, 3). In 28 patients, VDD mode was restored or maintained by increasing atrial sensitivity. No episodes of atrial oversensing were observed. In multivariate analysis history of paroxysmal AF (p = 0.007, odds ratio 36.6, 95% confidence interval 2.7-493.7) and p wave lower than 1 mv during the follow up (p = 0.021, odds ratio 7, 95% confidence interval 1.3-36.7), were found risk factors to VDD loss. CONCLUSIONS: VDD pacing has good long-term performance. Absence of paroxysmal AF history predicts maintenance of VDD pacing mode. Taking into account that no atrial oversensing was observed, our recommendation is to increase atrial sensitivity when P wave amplitude declines to less than 1 mv. |
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Authors:
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Miry Blich; Mahmoud Suleiman; Tawfiq Zeidan Shwiri; Ibrahim Marai; Monther Boulos; Shlomo Amikam |
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Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Clinical cardiology Volume: 33 ISSN: 1932-8737 ISO Abbreviation: Clin Cardiol Publication Date: 2010 Jan |
Date Detail:
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Created Date: 2010-01-18 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 7903272 Medline TA: Clin Cardiol Country: United States |
Other Details:
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Languages: eng Pagination: 18-22 Citation Subset: IM |
Copyright Information:
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Copyright 2010 Wiley Periodicals, Inc. |
Affiliation:
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Rambam Health Care Campus, Pacing and Electrophysiology Unit, Bat Galim Halfa, Israel. M blich@rambam.health.gov.il |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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