Document Detail


Pre-implant determinants of adequate long-term function of single lead VDD pacemakers.
MedLine Citation:
PMID:  12135244     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIMS: An inherent limitation of single lead VDD pacing is the inability to stimulate the atria. Reprogramming and upgrading the pacemaker system may be required when sinus node dysfunction, atrial undersensing, or atrial fibrillation develop. We evaluated whether routine clinical information is sufficient to select patients to benefit in long-term from VDD pacing. METHODS AND RESULTS: We collected data on 12-lead and monitored electrocardiograms and routine clinical information at implantation of a VDD pacing system in 350 consecutive patients with grade II or III atrioventricular conduction block. The age at implantation was 74.5 +/- 8.0 years, and the follow-up lasted 1.5 +/- 1.5 years. The cumulative maintenance of VDD pacing mode was 91.%. Loss of VDD mode was due to permanent atrial fibrillation in 16 (4.6%), sinus node dysfunction in six (1.7%). atrial undersensing in 11 (3.1%). Chronic atrial fibrillation developed in 23% of patients who had heart enlargement in chest x-ray and a history of paroxysmal atrial fibrillation or flutter. A criterion of normal sinus rate at implantation sufficiently predicted adequate sinus node function. Poor atrial sensing was not predicted by pre-implant characteristics. CONCLUSIONS: According to our data, adequate sinus-driven atrial rate and no history of paroxysmal atrial fibrillation and cardiac enlargement predict maintenance of the VDD pacing mode in elderly patients treated for heart block. Routine information available at implantation is sufficient to guide acceptance of single lead VDD pacing therapy.
Authors:
S Pakarinen; L Toivonen
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Europace : European pacing, arrhythmias, and cardiac electrophysiology : journal of the working groups on cardiac pacing, arrhythmias, and cardiac cellular electrophysiology of the European Society of Cardiology     Volume:  4     ISSN:  1099-5129     ISO Abbreviation:  Europace     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-07-23     Completed Date:  2003-01-14     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  100883649     Medline TA:  Europace     Country:  England    
Other Details:
Languages:  eng     Pagination:  137-41     Citation Subset:  IM    
Affiliation:
Division of Cardiology, Helsinki University, Central Hospital, Finland. sami.pakarinen@hus.fi
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MeSH Terms
Descriptor/Qualifier:
Aged
Cardiac Pacing, Artificial*
Equipment Design
Female
Humans
Male
Pacemaker, Artificial*
Retrospective Studies

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


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