Evidence Base for Pacemaker Mode Selection

Complications of Pacemaker Implantation

“…The majority of symptoms of PM syndrome are likely attributable to the reduction in cardiac output that is associated with right ventricular pacing. It induces a contraction similar to that caused by left bundle branch block, asynchronous ventricular contraction leading to altered diastolic filling time, increase in mitral regurgitation and reduction in left ventricular ejection fraction (Lamas & Ellenbogen, 2004). The cardiac output is greater during AAI pacing than with dual-pacing DDD.…”

Clinical Trials for Cardiac Pacing in Bradycardia

“…These perceived beneficial effects of physiological pacing were supported by early observations from short-term hemodynamic studies and retrospective analysis. 7 Indeed, the practice of physiological pacing has been widely adopted by implanting physicians. Recent surveys 3,8 have demonstrated that dual-chamber devices with rate-adaptive capabilities (DDDR) account for the majority (70%) of implanted pacemakers in Western countries and increasingly have been used in other parts of the world.…”

“…Moreover, as discussed by Healey et al, 16 the favorable hemodynamic effect of preserved AV synchrony may also be attenuated by "nonphysiological" ventricular dyssynchrony induced by right ventricular apical pacing. 7,18 The relative importance of AV versus ventricular synchrony on the long-term clinical outcome in patients with SSS should be addressed by the ongoing Danish Multicenter Randomized study on AAI or DDD Pacing in Sick Sinus Syndrome trial. 7 Third, an alternative approach of physiological pacing is needed in different populations of patients requiring pacemakers.…”

“…7,18 The relative importance of AV versus ventricular synchrony on the long-term clinical outcome in patients with SSS should be addressed by the ongoing Danish Multicenter Randomized study on AAI or DDD Pacing in Sick Sinus Syndrome trial. 7 Third, an alternative approach of physiological pacing is needed in different populations of patients requiring pacemakers. In patients with SSS and preserved AV conduction, unnecessary ventricular pacing should be avoided.…”

A novel non invasive measurement of hemodynamic parameters: Comparison of single-chamber ventricular and dual-chamber pacemaker

“…Non-invasive studies have failed to predict reliably which patients will derive the greatest benefit from AV synchrony. 6 However, current invasive and non-invasive measurement techniques were not practical and rather inconvenient for outpatients.…”