Pacemaker programming in patients with first-degree AV-block : Programming pattern and possible consequences
(2018) In Health Science Reports 1(6).- Abstract
Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)–block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization. Methods: The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation... (More)
Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)–block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization. Methods: The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation and postimplantation electrocardiograms were analyzed. Results: A total of 74 patients were included (mean age, 75 ± 11 y; 53% men). The mean ± SD preimplant PR interval and QRS duration was 243 ± 46 and 110 ± 30 milliseconds, respectively. A history of atrial fibrillation was present in 49% of the patients, and 77% had a normal left ventricular ejection fraction. The majority of patients (65%) had their pacemakers programmed to atrial pacing (AAI/DDD +/−R), whereas 32% and 2.7% of the pacemakers were programmed to AV-sequential pacing (DDD) and ventricular pacing (VVI), respectively. There were no significant differences in baseline characteristics or electrocardiogram measures between patients programmed to the 3 pacing modes. Patients with pacemakers programmed to AAI had a lower ventricular pacing percentage at follow-up (8 vs 55, and 46% [DDD and VVI, respectively]; P <.001). Conclusions: There was no evident association between baseline characteristics and programmed pacing mode in patients with first-degree AV-block. The choice of pacing mode affects long-term pacing burden, which in turn has been shown to influence outcome.
(Less)
- author
- Holmqvist, F. LU ; Rathakrishnan, B. ; Jackson, L. R. ; Campbell, K. and Daubert, J. P.
- organization
- publishing date
- 2018-06
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- first-degree AV-block, pacemaker programming, sinus node dysfunction
- in
- Health Science Reports
- volume
- 1
- issue
- 6
- article number
- e39
- publisher
- John Wiley & Sons Inc.
- external identifiers
-
- scopus:85083483956
- ISSN
- 2398-8835
- DOI
- 10.1002/hsr2.39
- language
- English
- LU publication?
- yes
- id
- 61e849dc-520a-481c-90db-278f1dea005c
- date added to LUP
- 2020-05-12 17:08:19
- date last changed
- 2022-04-18 22:33:07
@article{61e849dc-520a-481c-90db-278f1dea005c,
abstract = {{<p>Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)–block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization. Methods: The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation and postimplantation electrocardiograms were analyzed. Results: A total of 74 patients were included (mean age, 75 ± 11 y; 53% men). The mean ± SD preimplant PR interval and QRS duration was 243 ± 46 and 110 ± 30 milliseconds, respectively. A history of atrial fibrillation was present in 49% of the patients, and 77% had a normal left ventricular ejection fraction. The majority of patients (65%) had their pacemakers programmed to atrial pacing (AAI/DDD +/−R), whereas 32% and 2.7% of the pacemakers were programmed to AV-sequential pacing (DDD) and ventricular pacing (VVI), respectively. There were no significant differences in baseline characteristics or electrocardiogram measures between patients programmed to the 3 pacing modes. Patients with pacemakers programmed to AAI had a lower ventricular pacing percentage at follow-up (8 vs 55, and 46% [DDD and VVI, respectively]; P <.001). Conclusions: There was no evident association between baseline characteristics and programmed pacing mode in patients with first-degree AV-block. The choice of pacing mode affects long-term pacing burden, which in turn has been shown to influence outcome.</p>}},
author = {{Holmqvist, F. and Rathakrishnan, B. and Jackson, L. R. and Campbell, K. and Daubert, J. P.}},
issn = {{2398-8835}},
keywords = {{first-degree AV-block; pacemaker programming; sinus node dysfunction}},
language = {{eng}},
number = {{6}},
publisher = {{John Wiley & Sons Inc.}},
series = {{Health Science Reports}},
title = {{Pacemaker programming in patients with first-degree AV-block : Programming pattern and possible consequences}},
url = {{http://dx.doi.org/10.1002/hsr2.39}},
doi = {{10.1002/hsr2.39}},
volume = {{1}},
year = {{2018}},
}