TY - JOUR
T1 - DDD pacing mode survival in patients with a dual-chamber pacemaker
AU - Gross, Jay N.
AU - Moser, Stuart
AU - Benedek, Zoltan M.
AU - Andrews, Carolyn
AU - Furman, Seymour
PY - 1992/6
Y1 - 1992/6
N2 - Dual-chamber (DDD) pacing mode survival was assessed by reviewing 486 consecutive initial transvenous DDD pacemaker implantations between December 1981 and December 1988 inclusive, with a mean follow-up time of 33 months. The patients' mean age was 71.4 years and 55% were male; 38% had dominant sinoatrial and 62% had dominant atrioventricular (AV) node disease. Nineteen patients (4%) underwent secondary operative intervention for lead dislodgment (n = 11), lead or pulse generator malfunction (n = 6) or infection (n = 2). During follow-up, 87 patients (18%) had their device permanently reprogrammed out of the DDD mode and 10 others (2%) required temporary reprogramming out of this mode; 12 patients who required device reprogramming were managed in other dual-chamber or atrial pacing modes. Reasons for reprogramming included atrial fibrillation (n = 48; 10%); loss of atrial sensing (n = 26; 5%); recurrent "endless loop" tachycardia (n = 5; 1%); lead dislodgment without repositioning (n = 4; 1%); pulse generator malfunction (n = 1; 1%) and other (n = 5; 1%). The occurrence of atrial fibrillation was associated with dominant sinoatrial disease and a prior history of atrial fibrillation; 19% of atrial sensing loss was attributable to early or faulty pacemaker technology. The DDD mode survival rate at 1, 2, 3, 4 and 5 years was, respectively, 90%, 88%, 84%, 79% and 78%. It is concluded that 1) 4% of DDD pacemaker implants required secondary surgical intervention; 2) 82% of implanted pacemakers remained in the DDD mode throughout follow-up; 3) onset of atrial fibrillation or loss of atrial sensing accounted for 73% of the mode changes; 4) 10% of the permanent mode changes were directly related to early or defective pacemaker technology; and 5) DDD pacing remains a very reliable and effective long-term therapy in the majority of patients with a DDD pacemaker.
AB - Dual-chamber (DDD) pacing mode survival was assessed by reviewing 486 consecutive initial transvenous DDD pacemaker implantations between December 1981 and December 1988 inclusive, with a mean follow-up time of 33 months. The patients' mean age was 71.4 years and 55% were male; 38% had dominant sinoatrial and 62% had dominant atrioventricular (AV) node disease. Nineteen patients (4%) underwent secondary operative intervention for lead dislodgment (n = 11), lead or pulse generator malfunction (n = 6) or infection (n = 2). During follow-up, 87 patients (18%) had their device permanently reprogrammed out of the DDD mode and 10 others (2%) required temporary reprogramming out of this mode; 12 patients who required device reprogramming were managed in other dual-chamber or atrial pacing modes. Reasons for reprogramming included atrial fibrillation (n = 48; 10%); loss of atrial sensing (n = 26; 5%); recurrent "endless loop" tachycardia (n = 5; 1%); lead dislodgment without repositioning (n = 4; 1%); pulse generator malfunction (n = 1; 1%) and other (n = 5; 1%). The occurrence of atrial fibrillation was associated with dominant sinoatrial disease and a prior history of atrial fibrillation; 19% of atrial sensing loss was attributable to early or faulty pacemaker technology. The DDD mode survival rate at 1, 2, 3, 4 and 5 years was, respectively, 90%, 88%, 84%, 79% and 78%. It is concluded that 1) 4% of DDD pacemaker implants required secondary surgical intervention; 2) 82% of implanted pacemakers remained in the DDD mode throughout follow-up; 3) onset of atrial fibrillation or loss of atrial sensing accounted for 73% of the mode changes; 4) 10% of the permanent mode changes were directly related to early or defective pacemaker technology; and 5) DDD pacing remains a very reliable and effective long-term therapy in the majority of patients with a DDD pacemaker.
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U2 - 10.1016/0735-1097(92)90615-T
DO - 10.1016/0735-1097(92)90615-T
M3 - Article
C2 - 1593050
AN - SCOPUS:0026696713
SN - 0735-1097
VL - 19
SP - 1536
EP - 1541
JO - Journal of the American College of Cardiology
JF - Journal of the American College of Cardiology
IS - 7
ER -