Electrophysiological and haemodynamic basis for application of new pacemaker technology in sick sinus syndrome and atrioventricular block.
A fundamental description of pacemaker systems which are commercially available or in clinical validation is given as a background for their application in a series of 62 consecutive patients presenting over a period of 1 year for permanent cardiac pacing. The patients (23 (37%) sick sinus syndrome, 38 (61%) atrioventricular block, and 1 ventricular tachycardia) were studied electrophysiologically and haemodynamically to allow the appropriate application of a pacemaker system. In sick sinus syndrome, 8 patients had permanent atrial pacing, 14 ventricular pacing, and 1 atrioventricular sequential pacing; in atrioventricular block, 8 patients had atrial synchronous ventricular inhibited pacing and the remaining 30 had ventricular pacing. A high incidence of atrial fibrillation, 9 patients, and abnormal sinus node function, 15 patients, precluded wider use of atrial synchrony. The results show benefit in acute haemodynamic studies of using systems including atrial sensing and/or pacing, and with greater availability of atrioventricular sequential and still more advanced pacemakers with dual sensing as well as dual pacing the majority of patients may be offered this benefit.
D000368:Aged; D001146:Arrhythmia, Sinus / Q000503:physiopathology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial; D004562:Electrocardiography; D005260:Female; D006327:Heart Block / Q000503:physiopathology / Q000628:therapy*; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial