TY - GEN ID - cogprints4184 UR - http://cogprints.org/4184/ A1 - Farmer, Michael D A1 - Estes, Mark NA III A1 - Link, Mark S Y1 - 2004/10// N2 - After implantation of a permanent pacemaker, patients may experience severe symptoms of dyspnea, palpitations, malaise, and syncope resulting from pacemaker syndrome. Although pacemaker syndrome is most often ascribed to the loss of atrioventricular (A-V) synchrony, more recent data may also implicate left ventricular dysynchrony caused by right ventricular pacing. Previous studies have not shown reductions in mortality or stroke with rate-modulated dual-chamber (DDDR) pacing as compared to ventricular-based (VVI) pacing. The benefits in A-V sequential pacing with the DDDR mode are likely mitigated by the interventricular (V-V) dysynchrony imposed by the high percentage of ventricular pacing commonly seen in the DDDR mode. Programming DDDR pacemakers to encourage intrinsic A-V conduction and reduce right ventricular pacing will likely decrease heart failure and pacemaker syndrome. Studies are currently ongoing to address these questions. PB - Indian Pacing and Electrophysiology Group KW - VVI = ventricular-based KW - VVIR = rate modulated ventricular-based KW - A-V = atrioventricular KW - V-V = interventricular KW - V-A = ventricular-atrial KW - LBBB = left bundle branch block KW - LVEF = left ventricular ejection fraction KW - DDDR = rate modulated dual-chamber KW - SND = sinus node dysfunction KW - AAI = single-chamber atrial KW - AF = atrial fibrillation KW - LV = left ventricular KW - RV= right ventricular TI - New Concepts in Pacemaker Syndrome SP - 195 AV - public EP - 200 ER -