Pacing in children and young adults with nonsurgical atrioventricular block: Comparison of single-rate ventricular and dual-chamber modes

Congenital Complete Heart Block: Single Tertiary Centre Experience

“…This is in contrast to the findings of others such as Karpawich et al who compared VVI/DDD pacing and showed that although both pacing modes allowed increases in ventricular rate with exercise, VVI mode was associated with ectopy and greater risk for sudden death. At rest, patients in DDD mode also had comparatively slower resting sinus rates and better stroke volume, shortening fraction and cardiac output [19]. In our experience, both VVI and DDD pacemaker modes were met with good outcome.…”

Optimal Maximum Tracking Rate of Dual‐Chamber Pacemakers Required by Children and Young Adults for a Maximal Cardiorespiratory Performance

“…The results of single surveys for adult medical patients with a MTR of 130/min 9,10 are not transferable to the presently assessed cohort of patients because of the age and the concomitant comorbidities of the medical patients. Studies dealing with the optimal programming of pacemakers in children have mostly enrolled only small numbers patients and did not emphasize the optimal adjustment of the MTR 6,11–19 …”

“…Implantation of pacemakers in these patients is difficult because the pacemaker system is designed to be ideal for adults, and there are few data for the optimal adjustment of pacemaker parameters in this young age group. Since dual‐chamber pacemakers have beneficial effects on hemodynamics they are considered as the most appropriate systems of antibradycardic stimulation, 1,5 especially in children and adults 6,7 . However, there are no data concerning the optimum programming of the upper maximum tracking rate (MTR) limit of DDD‐pacemakers for a maximum of cardiorespiratory performance in this group.…”

Natural History and Current Therapy for Complete Heart Block in Children and Patients with Congenital Heart Disease

“…The 2 most common pacing modes in patients with complete heart block are single chamber ventricular demand pacing (VVI) and dual chamber AV sequential pacing (DDD, standard single‐site ventricular pacing). While the implantation of a single chamber system is less involved (single lead), the loss of AV synchrony has been reported to decrease cardiac output by as much as 23% 38 . Major advantages of a dual chamber (right atrium [RA] and right ventricle [RV]) pacing system include maintenance of physiologic heart rates and restoration of AV synchrony.…”