Retrospective anaylsis of long term single lead vdd follow-up data in MC Ljubljana

  • Luka Lipar
  • David Žižek
  • Igor Zupan
  • Wim Boute
  • Nace Kovačič
  • Peter Rakovec
Keywords: pacemakers, VDD, sensing threshold, AV synchrony, reprogramming

Abstract

Background: VDD pacing system offers physiologically beneficial atrio-ventricular (AV) synchronous pacing. The objective of our analysis was to evaluate changes of parameters that determine hemodynamic efficiency of pacing over time.

Methods: 358 patients who had implanted VDD pacemaker between May 1994 and September 2001 were retrospectively enrolled into our study. Data on P wave amplitudes, AV synchrony, AF burden and pacing mode were obtained from regular follow-up print outs.

Results: P wave amplitudes have lowered over years. Fourth year after implantation amplitudes were 81% of those one year after implantation. AV synchrony did not change over years and was nearly constant at 80%. AF burden has increased in 5 years for 65% according to first year after implantation. AF burden was higher with patients that had their devices implanted more than 5 years ago compared to those that had devices implanted less than 5 years ago. The difference was statistically significant (p < 0.05). VDD mode survival over 8 years was 88%. The most common indication for reprogramming was atrial fibrillation.

Conclusions: We may assume that VDD pacing system is reliable yet hemodinamically less efficient. It remains to be unclear whether this has an impact on the incidence of AF, therefore further studies are required.

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References

Ertas F, Karaoguz R, Guldal M, et al. Atrial sensing performance of a singlelead VDD pacing system during physical activities. J Electrocardiol 2000; 33: 253–60.

Pignalberi C, Ricci R, Canale G, et al. Paroxysmal atrial fibrillation in patients paced for atrioventricular block. Comparison between DDD and VDD single-lead pacing system. Ital Heart J 2001; 2: 772–7.

Wiegand UK, Schneider R, Bode F, et al. Atrial sensing and atrioventricular synchrony in single lead VDD pacemakers. Can the appearance of atrial undersensing be predicted? Z Kardiol 1997; 86: 95–104.

Boriani G, Biffi M, Bandini A, et al. DDD and single-lead VDD pacing: evaluation of atrial signal dynamic changes. Clin Cardiol 2000; 23: 678–80.

Nowak B, Middeldorf T, Voigtlander T, et al. How reliable is atrial sensing in single-lead VDD pacing: comparison of three systems. Pacing Clin Electrophysiol 1998; 21: 2226–31.

Huang M, Krahn AD, Yee R, Klein GJ, Skanes AC. Optimal pacing for symptomatic AV block: a comparison of VDD and DDD pacing. Pacing Clin Electrophysiol 2004; 27: 19–23.

Ector H, Rickards AF, Kappenberger L, et al. The registry of the European Working Group on Cardiac Pacing (EWGCP). A working group of the European Society of Cardiology. Europace 2000; 2: 251–5.

Žižek D, Lipar L, Zupan I, et al. Primerjava preddvorno-prekatne in sinhrone prekatne elektrostimulacije srca pri bolnikih s stalnimi srčnimi spodbujevalniki. Med Razgl 2004; 43: 19–31.

Ellenbogen KA, Wood MA, Stambler BS. Pacemaker syndrome: clinical hemodynamics and neurohumoral features. NY: Futura Publishing, 1993.

Ausubel K, Boal BH, Furman S. Pacemaker syndrom: definition and evaluation. Clin Cardiol 1985; 3: 587–94.

Schuchert A. Contributions of permanent cardiac pacing in the treatment of atrial fibrillation. Europace 2004; 5 Suppl 1: S36–41.

Chamberlain-Webber R, Barnes E, Papouchado M, Crick JP. Long-term survival of VDD pacing. Pacing Clin Electrophysiol 1998; 21: 2246–8.

Ibrahim B, Sanderson JE, Wright B, Palmer R. Dual chamber pacing: how many patients remain in DDD mode over the long term? Br Heart J, 1995; 74: 76–9.

How to Cite
1.
Lipar L, Žižek D, Zupan I, Boute W, Kovačič N, Rakovec P. Retrospective anaylsis of long term single lead vdd follow-up data in MC Ljubljana. TEST ZdravVestn [Internet]. 1 [cited 5Aug.2024];74. Available from: http://vestnik-dev.szd.si/index.php/ZdravVest/article/view/2189
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