Long-term follow-up of single-lead VDD pacing : cardiovascular topics
Cardiovascular journal of South Africa(2003)
Abstract
Long-term outcomes of single-lead VDD pacing were
studied retrospectively and partly prospectively. Records
were analysed of 81 patients out of 133 in whom a single-lead
VDD pacemaker was implanted between January
1993 and December 1997 and who attended a follow-up
clinic more than two years after the implant. Forty-eight
of them attended a prospective follow-up 54 ± 15 months
after the implant. Sinus rhythm was present in 91.5% of the patients
and atrial fibrillation in the remaining 8.5%. A-V synchronous
pacing was documented in 91.9 to 94.9% at different follow-up periods; however, an intermittent asynchronous
ventricular (VVI) pacing of more than 10%
occurred intermittently in 19.1% of the patients. Chronic
sensed P-wave amplitude was significantly lower than
the implant P-wave amplitude (by 70%) and did not correlate
with the implant amplitude. Postural changes
(supine, sitting, standing, with normal breathing and
during deep inspiration) did not have a significant
impact on sensed P-wave amplitude more than four
years after the implant. Rate histograms were remarkably
stable over the years, with dominant heart rate 70 to
79 beats per minute observed for 25 to 30% of the monitored
periods. Single-lead VDD pacing was found to be a reliable
method of long-term physiological pacing in patients
with heart block who returned for follow-up. Routine
testing more than four years after the implant does not
require postural manoeuvres.
MoreTranslated text
Key words
long-term,single-lead
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