title: [VDD mode single electrode cardiac stimulation: indications, results and limitations of the method].
abstract: 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.
authors.affiliation: Service de Cardiologie A, Hôpital Cardiologique, Lille.
authors.forename: Y
authors.initials: Y
authors.lastname: Ben Ameur
authors.forename: E
authors.initials: E
authors.lastname: Martin
authors.forename: M
authors.initials: M
authors.lastname: Jarwe
authors.forename: C
authors.initials: C
authors.lastname: Kouakam
authors.forename: D
authors.initials: D
authors.lastname: Klug
authors.forename: D
authors.initials: D
authors.lastname: Lacroix
authors.forename: P
authors.initials: P
authors.lastname: Lefranc
authors.forename: C
authors.initials: C
authors.lastname: De Gheldere
authors.forename: S
authors.initials: S
authors.lastname: Kacet
mesh_terms: 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
vernacular_title: La stimulation cardiaque en mode VDD à sonde unique: indications, résultats et limites de la méthode.