Occurrence and Significance of Arrhythmias Associated with Atrial‐Triggered Ventricular Pacing

Levander‐Lindgren, Maj; Pehrsson, S. Kenneth

doi:10.1111/j.1540-8159.1984.tb05589.x

Cited by 10 publications

(4 citation statements)

References 18 publications

(1 reference statement)

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“…Some previous studies have shown a lower incidence of AF in VDD follow‐up trials 2–5 in comparison with retrospective data of DDD pacemakers (Table I). 6–8 Folino et al 9 showed that the highest occurrence of AF was evident in patients with SSS and in patients with VVI stimulation (27%). Single lead VDD stimulation seemed to be the better mode of pacing in preventing AF (9%), while dual chamber pacing showed minor efficacy (25%) 9 .…”

Section: Discussionmentioning

confidence: 99%

“…There are two possible explanations for the higher AF incidence in DDD pacing. First, it has been suggested that atrial activity undersensing with an unsynchronized atrial pacing stimuli may trigger the occurrence of AF 8 . Second, the mechanical stimulation of the atrial lead at the RAA may induce AF.…”

Section: Discussionmentioning

confidence: 99%

“…First, it has been suggested that atrial activity undersensing with an unsynchronized atrial pacing stimuli may trigger the occurrence of AF. 8 Second, the mechanical stimulation of the atrial lead at the RAA may induce AF. Clinical study has found a shorter refractory period 21 and longer conduction delay 22 in patients with paroxysmal AF.…”

Section: Possible Mechanismsmentioning

confidence: 99%

“…Previous retrospective studies have shown a lower incidence of atrial fibrillation (AF) in VDD pacemakers than in DDD devices (0.4–2.7% 2–5 vs 3.4–10.0% 6–8 ) in patients with isolated AV block. A recent report revealed a similar highest incidence of AF in patients with VVI, DDD pacing (27 vs 25%) and the lowest incidence in single lead VDD stimulation (9%) 9 .…”

Section: Introductionmentioning

confidence: 99%

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Development of Atrial Fibrillation in Patients with Atrioventricular Block After Atrioventricular Synchronized Pacing

Kong

Tuan

Yin

et al. 2004

Pacing Clinical Electrophis

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Many studies have evidenced an increased incidence of AF in patients receiving single chamber ventricular pacing (VVI) when compared with those undergoing an atrial-based system (AAI or DDD). However, the difference in incidence of AF between two atrial-based systems (VDD, DDD) in patients with AV block was still controversial. This study was conducted to compare the development of AF between different modes of pacemakers (VDD and DDD) in patients with symptomatic AV block. A retrospective review was conducted of the detailed records of all consecutive patients who received permanent pacemakers due to symptomatic bradycardia from March 1995 to March 2000. The occurrence of AF was documented when there was presence of AF in the free-run or 12-lead ECG, any ECG strips, or persistent AF on 24-hour Holter ECG during the follow-up. The study included 152 patients (44 women, 108 men; mean age 73). The patients were divided into two groups: VDD (n = 100) and DDD (n = 52). The mean follow-up was 48.9 +/- 22.9 months. The incidence of AF was 7.9%. A higher incidence of AF was noted in the DDD group (15.4%) when compared with the VDD group (4.0%, P = 0.023). The incidence of development of AF in patients with AV block was higher in those receiving DDD cardiac pacing when compared with those who received the VDD system. The authors suggest that VDD pacing may be a better choice than the DDD system for patients with AV block, but without clinical evidence of sinus node dysfunction, and if an atrial lead is required, it should be placed close to the Bachmann's bundle.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Possible Mechanismsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Development of Atrial Fibrillation in Patients with Atrioventricular Block After Atrioventricular Synchronized Pacing

Kong

Tuan

Yin

et al. 2004

Pacing Clinical Electrophis

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Incidence and Management of Pacemaker‐related Complications during Dual‐chamber Pacing

Nordlander

1985

Journal of Internal Medicine

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Incidence and management of pacemaker-related complications during dual-chamber pacing. Acta Med Scand 1985; 218: 293-8. To evaluate the complication rate during AV universal pacing (DDD), 41 consecutive patients with complete heart block were studied and followed up for 2-30 (mean 10.8) months. The Cordis Sequicor Theta was used in 6 patients and the Siemens-Elema 674 in 35. Clinical problems related to the pacemaker treatment occurred in 12 patients (pacemaker tachycardia triggered by retrograde atrial activation in 2, atrial oversensing in 3 and undersensing in 2, ventricular oversensing in 2 and undersensing in I). Ventricular fibrillation occurred during threshold measurement in one patient. Seven of the problems could be ascribed to the DDD mode. Four of these 7 problems could be solved by reprogramming the pacemaker. A nonprogrammable atrial refractory period in the Cordis Sequicor was found to be a limitation in patients with endless loop tachycardia. In 3 cases reoperation had to be performed. In another 3 cases there were problems with ventricular sensing which in one could be solved by reprogramming. Apart from ventricular fibrillation, which could not be ascribed to the DDD mode, there were no serious problems in the clinical management of the patients.

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Atrial Synchronous Ventricular Inhibited (VDD) Pacemaker‐Mediated Arrhythmia Due to Atrial Undersensing and Atrial Lead Oversensing of Far‐Field Ventricular Afterpotentials or Paced Beats; Crosstalk

Johnson

1986

Pacing Clinical Electrophis

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A patient is described with an epicardial atrial or P wave synchronous ventricular inhibited VDD pacemaker which had atrial sensing malfunction manifesting as failure of atrial sensing, and atrial sensing of far-field ventricular polarization voltage afterpotentials or ventricular electrograms which mediated pacemaker allorhythms and tachycardias associated with dislocation of the atrial electrode near the right ventricle.

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Occurrence and Significance of Arrhythmias Associated with Atrial‐Triggered Ventricular Pacing

Cited by 10 publications

References 18 publications

Development of Atrial Fibrillation in Patients with Atrioventricular Block After Atrioventricular Synchronized Pacing

Development of Atrial Fibrillation in Patients with Atrioventricular Block After Atrioventricular Synchronized Pacing

Incidence and Management of Pacemaker‐related Complications during Dual‐chamber Pacing

Atrial Synchronous Ventricular Inhibited (VDD) Pacemaker‐Mediated Arrhythmia Due to Atrial Undersensing and Atrial Lead Oversensing of Far‐Field Ventricular Afterpotentials or Paced Beats; Crosstalk

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