Optimizing pacemaker longevity with pacing mode and settings programming: results from a pacemaker multicenter registry.
BACKGROUND
This study aimed to describe the influence on dual-chamber devices' expected longevity of devices' settings.


METHODS
Data from patients implanted with dual chamber devices (Symphony™, SORIN CRM SAS, Clamart, France) from 2003 to 2006 were collected in registries. Programmer files were retrieved: device-estimated longevity, assessed through algorithm prediction, was analyzed according to device settings.


RESULTS
One thousand sixty-eight recipients of dual chamber pacemaker in sinus rhythm (75.3±11.1 years, 54.5% male, ventricular block 30%, brady-tachy syndrome 21%, and sinus node dysfunction 49%) were followed up to 14.2±12.1 months (ranging from first quartile Q1: 2.9 months to fourth quartile Q4: 49.3 months) after implantation. DDD with automatic mode conversion and minimized ventricular pacing (SafeR) modes were programmed in 34.3%, 2.9%, and 62.8% of the patients, respectively. The mean total longevity estimated by the device was 134.1±31.5 months (11.2±2.6 years). Significant increase in longevity was observed in devices undergoing at least one reprogramming (134.4±31.4 months) versus device presenting no reprogramming (103.4±32.3 months, P=0.0005). The parameters associated with the major increase in mean longevity were the mode (mean longevity increase of +23.9 months in SafeR as compared to DDD mode, P<0.0001) and the atrial (A) and ventricular (V) amplitudes (mean longevity increase of +29.6 and +26.9 months for a decrease of less than 1V in A and V outputs respectively, P<0.0001).


CONCLUSIONS
This study provides information on dual chamber pacemakers' longevity and highlights the impact of devices' reprogramming on expected longevities.
Clinique St Pierre, Perpignan, France. henri.benkemoun@wanadoo.fr
Henri
H
Benkemoun
Jean
J
Sacrez
Philippe
P
Lagrange
Alain
A
Amiel
Atul
A
Prakash
Ewald
E
Himmrich
Ezio
E
Aimè
Georges H
GH
Mairesse
Christine
C
Guénon
Pascal
P
Sbragia
D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D001919:Bradycardia / Q000628:therapy; D002304:Cardiac Pacing, Artificial / Q000379:methods; D005260:Female; D006327:Heart Block / Q000628:therapy; D006801:Humans; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial; D012189:Retrospective Studies; D012804:Sick Sinus Syndrome / Q000628:therapy; D013577:Syndrome; D013610:Tachycardia / Q000628:therapy