[Analysis of the disturbances of cardiac pacing after single-pass lead VDD pacemaker implantation--long term follow up].
THIS STUDY: Evaluates complications related to permanent endocardial single-pass lead VDD pacing in the era of modern pacemaker therapy. VDD pacing is the optimal pacing mode for patients with atrio-ventricular block without sinus node dysfunction.


METHODS
167 (102 men, 65 female, mean age 65 +/- 15.7 yrs) patients, who received permanent VDD pacemakers between 2000-2005 yrs were reviewed retrospectively using patient records. Attention was paid to the occurrence of any complication/pseudo-malfunction during the first one year post implantation or long term follow-up. The duration of follow-up ranged 3-8 years (mean 5.6).


RESULTS
Complications was detected in 67 (40%) patients. An one year complication/pseudo-malfunction was detected in 23%, and 3% of patients were treated invasively. Late complication (after one year) developed 16% and reoperation was required in 2% of the patients. Inadequate capture or sensing was observed in 14% of the patients. Pacemaker infection was not observed. In 32 (19%) of patients we detected long periods of VVI pacing due to sinus rate fall below the lower limit of pacemaker rate.


CONCLUSIONS
Complications associated to modern permanent VDD pacemaker therapy are not infrequent. VDD pacing is a viable method in patients with symptomatic AV block. A great majority of the complications occurred within the first one year after implantation. The most pseudo-malfunction of VDD pacing was sinus bradycardia. In this group of patients VDD pacemaker usually necessitates reprogramming the lower pacing rate, the atrial/ventricular sensitivity and the strength of impulse.
Lelakowski
Jacek
J
Jagiellonian University, Collegium Medicum, John Paul II Hospital in Krakow Poland, Institute of Cardiology, Department of Electrocardiology. jlelakow@szpitaljp2.krakow.pl
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001919:Bradycardia / Q000209:etiology*; D002304:Cardiac Pacing, Artificial / Q000009:adverse effects*; D004868:Equipment Failure; D019544:Equipment Failure Analysis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016459:Prosthesis-Related Infections / Q000453:epidemiology / Q000209:etiology*; D012189:Retrospective Studies