Long-term follow-up of patients paced in VDD mode for advanced atrioventricular block: a pilot study.
OBJECTIVE
The aim of this pilot study was to estimate the survival trend of patients implanted with VDD pacemakers, and to compare it with the survival curve of the general population of the same region.


METHODS
Ninety-seven patients (65 male, mean age 78 +/- 6 years) with advanced atrioventricular block referred to our institution were implanted with single-lead VDD pacemakers. All patients were stimulated at the right ventricular apex. At each follow-up visit, a clinical examination was performed and telemetric data collected. In case of death, the family was contacted to record the cause of death. Data on the survival probability of the general population in the Marche Region were obtained from the Italian Institute of Statistics (ISTAT).


RESULTS
During the follow-up (mean 7 +/- 6 years), 17 patients (17.5%) died and eight patients (8.2%) developed atrial fibrillation. Atrioventricular synchrony was 97 +/- 3% in the overall patient population, excluding patients with atrial fibrillation. Only one patient was upgraded to DDD pacing owing to symptomatic loss of atrial sensing; after the upgrading procedure symptoms disappeared. During the follow-up period, 19 pacemakers were replaced for end of life of the battery. Patients who died during follow-up were aged 80 +/- 7 years at implantation and 85 +/- 6 years at death. The comparison between the trend line simulating the patient survival probability of the studied VDD population, and the survival probability of males in the Marche Region did not show any significant difference.


CONCLUSIONS
In patients chronically paced with a single-lead VDD system, survival probability seems to be similar to that of the general population.
Busacca
Paolo
P
Division of Cardiology-Intensive Care Unit, S. Maria della Misericordia Hospital, Urbino, Italy. paolobusacca@aliceposta.it
Gheller
Giuliano
G
Pupita
Mauro
M
Berzigotti
Giovanni
G
Generali
Carlo Alberto
CA
De Crescentini
Sandro
S
Gerardi
Paolo
P
Agostini
Alberto
A
Frattini
Claudio
C
Corbucci
Giorgio
G
Papi
Stefano
S
D000368:Aged; D000369:Aged, 80 and over; D054537:Atrioventricular Block / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D002304:Cardiac Pacing, Artificial / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D007558:Italy / Q000453:epidemiology; D008297:Male; D010138:Pacemaker, Artificial; D010865:Pilot Projects; D012189:Retrospective Studies; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome