%A Michael D Farmer %A Mark NA III Estes %A Mark S Link %J Indian Pacing and Electrophysiology Journal %T New Concepts in Pacemaker Syndrome %X 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. %N 4 %K VVI = ventricular-based, VVIR = rate modulated ventricular-based, A-V = atrioventricular, V-V = interventricular, V-A = ventricular-atrial, LBBB = left bundle branch block, LVEF = left ventricular ejection fraction, DDDR = rate modulated dual-chamber, SND = sinus node dysfunction, AAI = single-chamber atrial, AF = atrial fibrillation, LV = left ventricular, RV= right ventricular %P 195-200 %E Balbir Singh %E Yash Lokhandwala %E Johnson Francis %E Anup Gupta %V 4 %D 2004 %I Indian Pacing and Electrophysiology Group %L cogprints4184