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Single chamber atrial pacing: A realistic option in sinus node disease: A long-term follow-up study of 213 patients

Höijer, Carl Johan LU ; Höglund, Peter LU ; Schüller, Hans LU and Brandt, Johan LU (2007) In PACE 30(6). p.740-747
Abstract
Background: Despite several decades of experience with atrial pacing, many centers do not apply this mode to any greater extent, mainly because of concerns for the development of future atrioventricular (AV) block or atrial fibrillation. Recent studies have emphasized possible negative effects of right ventricular stimulation, even when AV-synchrony is preserved, and have thus given rise to renewed interest in single chamber atrial pacing for sinus node disease. Methods: This study presents the results of up to 19 years' follow-up of 213 patients with sinus node disease treated with atrial pacing with respect to survival and causes of death, development of atrial fibrillation and AV block, and total mode survival. Patients were divided... (More)
Background: Despite several decades of experience with atrial pacing, many centers do not apply this mode to any greater extent, mainly because of concerns for the development of future atrioventricular (AV) block or atrial fibrillation. Recent studies have emphasized possible negative effects of right ventricular stimulation, even when AV-synchrony is preserved, and have thus given rise to renewed interest in single chamber atrial pacing for sinus node disease. Methods: This study presents the results of up to 19 years' follow-up of 213 patients with sinus node disease treated with atrial pacing with respect to survival and causes of death, development of atrial fibrillation and AV block, and total mode survival. Patients were divided into two groups: with or without associated atrial tachyarrhythmias at the time of implant. Results are given for all patients and for the two groups separately. Results: The mean follow-up time was 10.1 years. The survival of the entire group was lower after 10 years than that of an age and gender-matched general Swedish population. This was caused by patients with the brady-tachy syndrome (BT) having a significantly higher mortality rate than controls, whereas those with bradycardia only (B) had survival comparable to the general population. Permanent atrial fibrillation (AF) developed in 20% of patients and was significantly more common in patients with BT. The majority of patients with AF (78%) no longer needed any pacing, i.e., did not require ventricular stimulation due to slow ventricular rate. The annual incidence of high grade AV block was 1.8%. If patients with preexisting bundle branch block were excluded, the incidence was 1.6%. No fatal episode of AV block was seen. The overall mode survival at the end of follow-up was 75%, with 155 patients still with atrial pacemakers. Conclusion: Atrial pacing is a safe and reliable mode of pacing in patients with sinus node disease, even in the very long-term. (Less)
Please use this url to cite or link to this publication:
author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
pacing, trials
in
PACE
volume
30
issue
6
pages
740 - 747
publisher
Wiley-Blackwell
external identifiers
  • wos:000247679200004
  • scopus:34249790844
ISSN
1540-8159
DOI
10.1111/j.1540-8159.2007.00744.x
language
English
LU publication?
yes
id
1b133948-46cd-4be7-a278-22572801507e (old id 648693)
alternative location
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=17547606&dopt=Abstract
date added to LUP
2007-12-12 14:30:08
date last changed
2017-01-01 07:20:13
@article{1b133948-46cd-4be7-a278-22572801507e,
  abstract     = {Background: Despite several decades of experience with atrial pacing, many centers do not apply this mode to any greater extent, mainly because of concerns for the development of future atrioventricular (AV) block or atrial fibrillation. Recent studies have emphasized possible negative effects of right ventricular stimulation, even when AV-synchrony is preserved, and have thus given rise to renewed interest in single chamber atrial pacing for sinus node disease. Methods: This study presents the results of up to 19 years' follow-up of 213 patients with sinus node disease treated with atrial pacing with respect to survival and causes of death, development of atrial fibrillation and AV block, and total mode survival. Patients were divided into two groups: with or without associated atrial tachyarrhythmias at the time of implant. Results are given for all patients and for the two groups separately. Results: The mean follow-up time was 10.1 years. The survival of the entire group was lower after 10 years than that of an age and gender-matched general Swedish population. This was caused by patients with the brady-tachy syndrome (BT) having a significantly higher mortality rate than controls, whereas those with bradycardia only (B) had survival comparable to the general population. Permanent atrial fibrillation (AF) developed in 20% of patients and was significantly more common in patients with BT. The majority of patients with AF (78%) no longer needed any pacing, i.e., did not require ventricular stimulation due to slow ventricular rate. The annual incidence of high grade AV block was 1.8%. If patients with preexisting bundle branch block were excluded, the incidence was 1.6%. No fatal episode of AV block was seen. The overall mode survival at the end of follow-up was 75%, with 155 patients still with atrial pacemakers. Conclusion: Atrial pacing is a safe and reliable mode of pacing in patients with sinus node disease, even in the very long-term.},
  author       = {Höijer, Carl Johan and Höglund, Peter and Schüller, Hans and Brandt, Johan},
  issn         = {1540-8159},
  keyword      = {pacing,trials},
  language     = {eng},
  number       = {6},
  pages        = {740--747},
  publisher    = {Wiley-Blackwell},
  series       = {PACE},
  title        = {Single chamber atrial pacing: A realistic option in sinus node disease: A long-term follow-up study of 213 patients},
  url          = {http://dx.doi.org/10.1111/j.1540-8159.2007.00744.x},
  volume       = {30},
  year         = {2007},
}