Atrioventricular pacemaker. Incidence and causes of reprogramming in long-term follow-up

Abstract

Objective -To assess the incidence of problems requiring reprogramming of atrioventricular pacemakers in a long-term follow-up, and also the causes for this procedure. December '99, 657 patients were retrospectively studied, An actuarial curve for the event reprogramming of the stimulation mode was drawn. Methods -During the period from May '98 to Results -The follow-up period ranged from 12 to 178 months (mean = 81 months

Long-term follow-up of DDD pacing mode

“…Though this value is higher than in other studies, in equally long durations of follow-up our percentage of the loss of DDD is the same or even lower. A five-year cumulative rate of DDD pacing survival was 87%, whereas in other studies it was 78-90% [14][15][16].…”

“…Gross et al [14] and Ibrahim et al [15] showed that DDD pacing mode survival after five years was, respectively, 78% and 83.5%. In longer follow-up (an average of 81 months), DDD pacing mode survival after five years was 90%, and after 15 years -58% [16]. In a study investigating a Polish population of 295 patients with DDD pacemakers implanted between 1994 and 1997, Majewski et al [17] reported that after an average of 63 months of follow-up, pacing mode was changed to VVI in 18% of patients; in 13% of patients there occurred permAF, and in 5% atrial lead damage.…”

“…Most studies on the long-term efficacy of DDD pacing are retrospective and come from the early period of implantation history -the 1980s and early 90s. In the cited articles, a follow-up of nearly 3,000 dual-chamber pacemaker patients is described [11][12][13][14][15][16]. In the follow-up periods ranging from 30 to 44 months, it was necessary to abandon DDD stimulation in 4.3-18% of cases.…”

Follow up and optimisation of cardiac pacing

“…9 The most common reason (38%) for reprogramming a pacemaker at the time of follow up is for an arrhythmia and the most frequent programming change is the stimulation mode (81%). 10 Fast tracking of atrial tachyarrhythmias is usually prevented by algorithms known as automatic mode switching (AMS). 11 12 The detection of the atrial arrhythmia will depend on the algorithm but usually involves the detection of sudden onset of a fast atrial rate.…”

Caso 06/2005: insuficiência cardíaca progressiva em paciente de 65 anos de idade portador de marcapasso cardíaco artificial

“…Existem relatos de que a presença de eletrodo atrial poderia aumentar a incidência de arritmia atrial; no entanto, essa relação não é freqüente e torna-se secundária diante dos benefícios que uma estimulação atrioventricular pode trazer 17 .…”