[Clinical safety and efficacy of single-chamber atrial pacing in sick sinus syndrome: long-term follow-up].
OBJECTIVE
Although atrial pacing is a more physiological mode of stimulation in sinus node dysfunction, the pacing modes most often are used DDD and VVI. The aim of our study was to demonstrate that AAI/AAIR pacing is effective and safe by analyzing the complications and mortality of this pacing mode in a long-term follow-up study.


METHODS
Between 1982 and 2000 definitive AAI-mode pacemakers were implanted for sinus node dysfunction in mode AAI in 160 patients. We analyzed the clinical characteristics, evolution, and complications of the AAI pacing mode during a follow-up of 5.4 4.5 years.


RESULTS
The sample was made up of 104 women and 56 men with an average age of 72 12 years. During follow-up, it was necessary to change the pacing mode for symptomatic bradycardia in 11 patients (annual incidence 1.2%), which was caused by second or third-degree atrioventricular block in 7 patients (annual incidence 0.8%), and chronic atrial fibrillation with bradycardia in 4 patients (annual incidence 0.4%). During follow-up, atrial arrhythmias occurred in 32 patients (annual incidence 3.7%), stroke in 4 patients (annual incidence 0.4%), and 27 patients (annual incidence 3.1%) died.


CONCLUSIONS
The AAI/AAIR pacing mode was safe and effective in sinus node dysfunction, with a low percentage of pacing changes required for progression to atrioventricular block, low incidence of atrial arrhythmias, stroke and low mortality during long term follow-up.
Moríñigo
Jose L
JL
Servicio de Cardiología. Hospital Clínico Universitario de Salamanca. España. jlmori@eresmas.com
Arribas
Antonio
A
Ledesma
Claudio
C
Sánchez
Pedro L
PL
Martín
Francisco
F
Martín Luengo
Cándido
C
D000368:Aged; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D012449:Safety; D012804:Sick Sinus Syndrome / Q000628:therapy*; D012849:Sinoatrial Node / Q000502:physiology; D016896:Treatment Outcome