[Frequency of atrial pacing in patients with intermittent atrial fibrillation and 2nd or 3rd degree atrioventricular block. Thera DR Pacemaker Study Group].
Patients with 2nd or 3rd degree AV-block and paroxysmal atrial fibrillation could be suitable for VDDR pacemakers, if they are not or rarely paced in the atrium. We studied in 23 of these patients 1 month after DDDR pacemaker implantation, how often they were paced in the atrium with usual pacemaker programmings; patients with < 10% atrial pacing were compared with patients with > or = 10% atrial pacing. In case automatic mode switch was programmed, the number of mode switch episodes was assessed as a marker for the frequency of atrial tachyarrhythmias. Atrial pacing < 10% of the time occurred in seven, pacing from 10 to 19% in six, from 20 to 29% in two, and > or = 30% of the time in eight patients. Five of the seven patients with < 10% atrial pacing were paced in the DDD mode, but only four of 16 patients with > or = 10%. Usual clinical findings were unable to predict patients with rare atrial pacing. Patients with < 10% as well as with > or = 10% atrial pacing had < 10 mode switch episodes in 67% each.


CONCLUSIONS
During short-term follow-up after DDDR pacemaker implantation 30% of the patients with paroxysmal atrial fibrillation and second or third degree AV-block, with present usual pacemaker programmings, rarely had atrial pacing, that means < 10% of the time. These patients would be probably suitable for VDDR pacemakers. Rare atrial pacing had no influence on the occurrence of automatic mode switch episodes.
Schuchert
A
A
Abteilung für Kardiologie, Medizinische Klinik, Universitäts-Krankenhaus Eppendorf, Hamburg.
van Langen
H
H
Michels
K
K
Meinertz
T
T
D000328:Adult; D000368:Aged; D001281:Atrial Fibrillation / Q000503:physiopathology / Q000628:therapy*; D001283:Atrioventricular Node / Q000503:physiopathology; D017115:Catheter Ablation; D015716:Electrocardiography, Ambulatory / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006327:Heart Block / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000706:statistics & numerical data*; D011183:Postoperative Complications / Q000503:physiopathology / Q000628:therapy; D012984:Software; D013614:Tachycardia, Paroxysmal / Q000503:physiopathology / Q000628:therapy*; D016896:Treatment Outcome