Optimal pacing for symptomatic @entity713 : a comparison of VDD and XXXX pacing.

@entity1 @entity1817 @entity713 @entity3603
VDD pacing provides the physiological benefits of atrioventricular synchronous pacing with the convenience of a single lead system, but is hampered by uncertainty regarding long-term atrial sensing and potential development of @entity1817 . To examine the long-term reliability and complication rates of VDD pacing, we compared the outcome of 112 consecutive @entity1 (age 70 +/- 13 years, 59% male) with symptomatic @entity713 who received a single pass bipolar VDD system to 80 @entity1 (age 63 +/- 16 years, 70% male) who received @entity3603 pacing for the same indication. All @entity1 were judged to have intact sinus node function based on submitted ECGs and monitoring results at the time of implant. Implant time was reduced in VDD @entity1 compared to @entity3603 @entity1 (63 +/- 20 vs 97 +/- 36 minutes, P < 0.0001). Implant complications occurred in 5 (6%) @entity3603 @entity1 compared to 3 (3%) VDD @entity1 (P = 0.15). The implant P wave was lower with VDD pacing compared to @entity3603 @entity1 (2.91 +/- 1.48 vs 4.0 +/- 1.7 mV, P < 0.0001), but remained stable during long-term follow-up in both groups. During 17.7 +/- 10.0 months of follow-up in the VDD group, only 2 VDD @entity1 were reprogrammed to VVIR mode, compared to 3 @entity3603 @entity1 . Physiological atrioventricular activation was maintained in 94%-99% of beats throughout the follow-up period in the VDD group. VDD pacing is an excellent strategy for treatment of @entity1 with symptomatic @entity713 . The lower cost, high reliability, and abbreviated implantation time suggest that VDD pacing is a viable alternative to @entity3603 pacing in @entity1 with high-degree @entity713 and normal sinus node function.
