Document Detail


Optimal pacing for symptomatic AV block: a comparison of VDD and DDD pacing.
MedLine Citation:
PMID:  14675005     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
VDD pacing provides the physiological benefits of atrioventricular synchronous pacing with the convenience of a single lead system, but is hampered by uncertainty regarding long-term atrial sensing and potential development of sinus node disease. To examine the long-term reliability and complication rates of VDD pacing, we compared the outcome of 112 consecutive patients (age 70 +/- 13 years, 59% male) with symptomatic AV block who received a single pass bipolar VDD system to 80 patients (age 63 +/- 16 years, 70% male) who received DDD pacing for the same indication. All patients were judged to have intact sinus node function based on submitted ECGs and monitoring results at the time of implant. Implant time was reduced in VDD patients compared to DDD patients (63 +/- 20 vs 97 +/- 36 minutes, P < 0.0001). Implant complications occurred in 5 (6%) DDD patients compared to 3 (3%) VDD patients (P = 0.15). The implant P wave was lower with VDD pacing compared to DDD patients (2.91 +/- 1.48 vs 4.0 +/- 1.7 mV, P < 0.0001), but remained stable during long-term follow-up in both groups. During 17.7 +/- 10.0 months of follow-up in the VDD group, only 2 VDD patients were reprogrammed to VVIR mode, compared to 3 DDD patients. Physiological atrioventricular activation was maintained in 94%-99% of beats throughout the follow-up period in the VDD group. VDD pacing is an excellent strategy for treatment of patients with symptomatic AV block. The lower cost, high reliability, and abbreviated implantation time suggest that VDD pacing is a viable alternative to DDD pacing in patients with high-degree AV block and normal sinus node function.
Authors:
Max Huang; Andrew D Krahn; Raymond Yee; George J Klein; Allan C Skanes
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Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Pacing and clinical electrophysiology : PACE     Volume:  26     ISSN:  0147-8389     ISO Abbreviation:  Pacing Clin Electrophysiol     Publication Date:  2003 Dec 
Date Detail:
Created Date:  2003-12-16     Completed Date:  2004-07-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7803944     Medline TA:  Pacing Clin Electrophysiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  2230-4     Citation Subset:  IM    
Affiliation:
Division of Cardiology, University of Western Ontario, London Ontario Canada.
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MeSH Terms
Descriptor/Qualifier:
Aged
Equipment Design
Female
Follow-Up Studies
Heart Block / therapy*
Humans
Male
Middle Aged
Pacemaker, Artificial* / adverse effects
Retrospective Studies
Time Factors

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


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