creators_name: Shah, Ashok
creators_name: Aithal, Jairam
creators_name: Narula, Dhiraj
creators_name: Kerkar, Prafulla
editors_name: Singh, Balbir
editors_name: Lokhandwala, Yash
editors_name: Francis, Johnson
editors_name: Gupta, Anup
editors_name: Ghosh, Joydeep
type: journalp
datestamp: 2006-10-28
lastmod: 2011-03-11 08:56:42
metadata_visibility: show
title: Stable Atrial Sensing on Long-Term Follow Up of VDD Pacemakers

ispublished: pub
subjects: ipej
full_text_status: public
keywords: VDD Lead; P wave Amplitude; Atrial Sensitivity; Atrioventricular synchronous Pacing
abstract: Background:
            The hemodynamic advantages of maintaining AV synchrony through AV synchronous pacing are widely known as compared to single chamber pacing. DDD pacemaker implantation entails higher cost and is technically more challenging than the VDD pacemaker.

Methods:
            Seventy one patients underwent VDD lead (Biotronik GmbH, St. Jude Medical and Medtronic Inc.) implantation at KEM hospital, Mumbai during a period of 3 years through subclavian, axillary and cephalic routes for degenerative, post-surgical or congenital high grade atrioventricular or complete heart block. They were followed up regularly for ventricular threshold and P wave amplitude of the floating atrial dipole.

Results:
            Follow up data of almost 95% of patients is available for a period of 15.8 ± 6.7 months. P wave amplitude at implant was 2.1 ± 0.7mV and at follow up 1.1 ± 0.6mV with mean ventricular threshold of <0.5V at implant and <1V at follow-up.

Conclusion:
            Implantation of a single lead VDD pacemaker is possible in all patients with symptomatic AV block and intact sinus node function without any technical complications. P wave sensing is reliable and consistent with floating atrial lead at an average follow up of 15.8 months, providing an excellent alternative to DDD pacemaker implantation.

date: 2006-07
date_type: published
publication: Indian Pacing and Electrophysiology Journal
volume: 6
number: 4
publisher: Indian Pacing and Electrophysiology Group
pagerange: 189-193
refereed: TRUE
referencetext: 1. Bernstein AD, Parsonnet V. World Survey 1993. Reblampa 1995;8 (special issue):135-137.

2. Brownlee WC, Hirst RM. 6 years experience with atrial leads. PACE 1989;12:678-681.

3. Frohlig G, Blank W, Schwerdt H. Atrial sensing performance of AV universal pacemaker during exercise. PACE 1988;11:47-60.

4. Frohlig G, Schwerdt H, Scheiffer H. Atrial signal variations and pacemaker malsensing during exercise: a study in the time and frequency domain. J Am Coll Cardio 1988;11(4):806-813 

5. Zitzmann E, Coenen M, Heinz M. Malfunction of dual chamber pacemakers (abstract). Z Kardiol 1990;79(Suppl 1):179.

6. Andreas L, Johannes M, Cornelius K, Hermann A, Dietrich E. Clinical results with single lead VDD pacing. European Journal of Cardio-thoracic Surgery 1997;11:722-727.

7. Antoonioli GE. The Italian Saphir Clinical and Technical Evaluation Group. A new VDDR single lead pacing system: a multicentre clinical study. PACE 1995;18:1769.

8. Nurnberg M, Steinbach K, Cerchez T et al. Clinical investigation of a single new pass lead VDD system. PACE 1995;18:1769.

9. Senden J, Kammeyer W, Landman M, Corstjens J, Schalij M. Single pass VDD experience with orthogonal as longitudinal placed bipolar atrial electrodes using a dedicated DDDR pacemaker. PACE 1995;18:1793.

10. Chiladakis JA, Patsouras N, Agelopoulos G, Nikolopoulos N, Manolis AS. Comparative three-year Performance of Chronic Atrial Sensing among eight different VDD systems. Am J Cardiol 2002;89:1215-1218.

11. Antonioli GE, Ansani L, Barbieri D. Italian multicentre study on a single lead VDD pacing using a narrow atrial dipole spacing. PACE 1992;15:1890-1893.

12. Parravicini U, Zanetta M, Zenone F. Complications of VDD single lead pacing in 35 patients with AV block. PACE 1992;15:1901-1902.

13. Tse HF, Lau CP, Leung SK. Limitation of long-term atrial pacing via floating ring electrode using overlapping Biphasic impulse stimulation in ambulatory-paced patients. Am J Cardiol 1998;81:645-647.





        

citation:   Shah, Ashok and Aithal, Jairam and Narula, Dhiraj and Kerkar, Prafulla  (2006) Stable Atrial Sensing on Long-Term Follow Up of VDD Pacemakers.  [Journal (Paginated)]     
document_url: http://cogprints.org/5241/1/shah.htm
document_url: http://cogprints.org/5241/2/shah.pdf