Left atrial appendage function during DDD and VVI pacing.
OBJECTIVE
To examine, using transoesophageal echocardiography, the possible disturbances of left atrial appendage function during VVI and DDD pacing in patients with a normal atrium paced with a dual chamber system.


METHODS
Randomised controlled trial.


METHODS
Tertiary care centre.


METHODS
22 patients (mean age 68 (SD 6) years) who had been paced with dual chamber pacemakers for at least six months. Exclusion criteria were valvar disease, cardiomyopathy, hypertension, and diabetes mellitus.


METHODS
All patients underwent a transoesophageal echocardiographic evaluation of left atrial appendage function under DDD and VVI modes in random order. Measurements were made after at least two months' pacing in each mode.


METHODS
Echocardiographic indices of left atrial appendage flow under both pacing modes.


RESULTS
All 22 patients had higher emptying and filling flow velocities under DDD than under VVI mode. The filling and emptying flow velocity integrals were also significantly higher under DDD mode (P < 0.001, P = 0.019).


CONCLUSIONS
Left atrial appendage function, as reflected in indices of emptying and filling assessed by transoesophageal echocardiography, is significantly different with DDD than with VVI pacing. This may explain the higher incidence of thromboembolic episodes in patients paced under VVI mode.
Simantirakis
E N
EN
Cardiology Department, University Hospital of Heraklion, Crete, Greece.
Parthenakis
F I
FI
Chrysostomakis
S I
SI
Zuridakis
E G
EG
Igoumenidis
N E
NE
Vardas
P E
PE
D000368:Aged; D016279:Atrial Function, Left; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D018619:Echocardiography, Doppler, Pulsed; D017548:Echocardiography, Transesophageal; D005260:Female; D006327:Heart Block / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D012804:Sick Sinus Syndrome / Q000000981:diagnostic imaging / Q000503:physiopathology / Q000628:therapy*