DDD pacing mode survival in patients with a dual-chamber pacemaker

Jay N. Gross, Stuart Moser, Zoltan M. Benedek, Carolyn A. Andrews, Seymour Furman

Research output: Contribution to journalArticle

52 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)1536-1541
Number of pages6
JournalJournal of the American College of Cardiology
Volume19
Issue number7
DOIs
StatePublished - 1992

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Dichlorodiphenyldichloroethane
Survival
Atrial Fibrillation
Technology
Equipment and Supplies
Atrioventricular Node
Tachycardia
Survival Rate

ASJC Scopus subject areas

  • Nursing(all)

Cite this

DDD pacing mode survival in patients with a dual-chamber pacemaker. / Gross, Jay N.; Moser, Stuart; Benedek, Zoltan M.; Andrews, Carolyn A.; Furman, Seymour.

In: Journal of the American College of Cardiology, Vol. 19, No. 7, 1992, p. 1536-1541.

Research output: Contribution to journalArticle

Gross, Jay N. ; Moser, Stuart ; Benedek, Zoltan M. ; Andrews, Carolyn A. ; Furman, Seymour. / DDD pacing mode survival in patients with a dual-chamber pacemaker. In: Journal of the American College of Cardiology. 1992 ; Vol. 19, No. 7. pp. 1536-1541.
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title = "DDD pacing mode survival in patients with a dual-chamber pacemaker",
abstract = "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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