title: Comparison of DDD versus VVIR pacing modes in elderly patients with atrioventricular block.
abstract: OBJECTIVE
  Dual-chamber pacing is believed to have an advantage over single-chamber ventricular pacing. The aim of this study was to determine whether elderly patients who have implanted pacemakers for complete atrioventricular block gain significant benefits from dual-chamber (DDD) pacemakers compared with single chamber ventricular (VVIR) pacemakers.
  
  
  METHODS
  This study was designed as a randomized, two-period crossover study-each pacing mode was maintained for 1 month. Thirty patients (16 men, mean age 68.87 ± 6.89 years) with implanted DDD pacemakers were submitted to a standard protocol, which included an interview, pacemaker syndrome assessment, health related quality of life (HRQoL) questionnaires assessed by an SF-36 test, 6-minute walk test (6MWT), and transthoracic echocardiographic examinations. All of these parameters were obtained on both DDD and VVIR mode pacing. Paired data were compared.
  
  
  RESULTS
  HRQoL scores were similar, and 6MWT results did not differ between the two groups. VVIR pacing elicited significant enlargement of the left atrium and impaired left ventricular diastolic functions as compared with DDD pacing. Two patients reported subclinical pacemaker syndrome, but this was not statistically significant.
  
  
  CONCLUSIONS
  Our study revealed that in active elderly patients with complete heart block, DDD pacing and VVIR pacing yielded similar improvements in QoL and exercise performance. However, after a short follow-up period, we noted that VVIR pacing caused significant left atrial enlargement and impaired left ventricular diastolic functions.
authors.affiliation: Department of Cardiology, Medeniyet University Göztepe Training and Research Hospital, İstanbul, Turkey. kilicaslanbaris@yahoo.com
authors.forename: Barış
authors.initials: B
authors.lastname: Kılıçaslan
authors.forename: Fahriye
authors.initials: F
authors.lastname: Vatansever Ağca
authors.forename: Esin Evren
authors.initials: EE
authors.lastname: Kılıçaslan
authors.forename: Ozan
authors.initials: O
authors.lastname: Kınay
authors.forename: Kürşat
authors.initials: K
authors.lastname: Tigen
authors.forename: Cayan
authors.initials: C
authors.lastname: Cakır
authors.forename: Cem
authors.initials: C
authors.lastname: Nazlı
authors.forename: Oktay
authors.initials: O
authors.lastname: Ergene
mesh_terms: D000368:Aged; D054537:Atrioventricular Block / Q000628:therapy*; D018592:Cross-Over Studies; D004452:Echocardiography; D005080:Exercise Test; D005260:Female; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D010138:Pacemaker, Artificial / Q000009:adverse effects / Q000145:classification* / Q000592:standards; D011788:Quality of Life; D011795:Surveys and Questionnaires