[VDD mode single electrode cardiac stimulation: indications, results and limitations of the method].
Several authors have reported the single atrioventricular (AV) electrode, comprising an atrial dipole floating in the right atrium, to be a system capable of providing results which are just as satisfactory as those of conventional systems (DDD). Between August 1992 and March 1995, a VDD single electrode pacemaker was implanted in 65 patients (mean age: 73 years +/- 17.2). The indication for implantation was isolated high degree AVB with no apparent sinus dysfunction. Four pacemakers were used: Vitatron (n = 24), Intermedics (n = 23), Medico (n = 13), Biotronik (n = 5). Intraoperative atrial endocavitary recording was 1.8 mV +/- 0.74. 17 patients died from a cause unrelated to pacemaker dysfunction. 4 patients were lost to follow-up. The remaining 44 patients were reviewed in our centre with a mean follow-up of 14.5 months +/- 7 months. Seven pacemakers (16%) were reprogrammed in VVI or VVI (R) mode, because of permanent atrial fibrillation in 3 cases, complete loss of atrial reception in 2 cases and late onset sinus dysfunction in 1 case. In the 41 patients in sinus atrial rhythm, the atrioventricular synchronization rate was greater than 90% in 88% of patients, equal to 76.3% in 2.4% of patients and atrioventricular synchronization was impossible in 9.6% of cases.


CONCLUSIONS
The overall results of our preliminary experience of VDD mode single electrode pacemaker are moderate. The poor results essentially concerned patients with paroxysmal atrial arrhythmias prior to pacing.
Ben Ameur
Y
Y
Service de Cardiologie A, Hôpital Cardiologique, Lille.
Martin
E
E
Jarwe
M
M
Kouakam
C
C
Klug
D
D
Lacroix
D
D
Lefranc
P
P
De Gheldere
C
C
Kacet
S
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D005069:Evaluation Studies as Topic; D005500:Follow-Up Studies; D006327:Heart Block / Q000601:surgery*; D006801:Humans; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012189:Retrospective Studies
La stimulation cardiaque en mode VDD à sonde unique: indications, résultats et limites de la méthode.