New concepts in pacemaker syndrome

Farmer, Michael D; Estes, Mark, III and Link, Mark S (2004) New concepts in pacemaker syndrome. Indian Pacing and Electrophysiology Journal, 4 (4). pp. 195-200. ISSN 0972-6292

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Abstract

After implantation of a permanent pacemaker, patients may experience severe symptoms of dyspnea, palpitations, malaise, and syncope resulting from pacemaker syndrome. Although pacemaker syndrome is most often ascribed to the loss of atrioventricular (A-V) synchrony, more recent data may also implicate left ventricular dysynchrony caused by right ventricular pacing. Previous studies have not shown reductions in mortality or stroke with rate-modulated dual-chamber (DDDR) pacing as compared to ventricular-based (VVI) pacing. The benefits in A-V sequential pacing with the DDDR mode are likely mitigated by the interventricular (V-V) dysynchrony imposed by the high percentage of ventricular pacing commonly seen in the DDDR mode. Programming DDDR pacemakers to encourage intrinsic A-V conduction and reduce right ventricular pacing will likely decrease heart failure and pacemaker syndrome. Studies are currently ongoing to address these questions.

EPrint Type:Article
Uncontrolled Keywords: VVI = ventricular-based, VVIR = rate modulated ventricular-based, A-V = atrioventricular, V-V = interventricular, V-A = ventricular-atrial, LBBB = left bundle branch block, LVEF = left ventricular ejection fraction, DDDR = rate modulated dual-chamber, SND = sinus node dysfunction, AAI = single-chamber atrial, AF = atrial fibrillation, LV = left ventricular, RV= right ventricular
Subjects:Equipment and Supplies > Surgical Equipment > Artificial Organs > Pacemaker, Artificial
Cardiovascular Diseases > Heart Diseases > Arrhythmia
Pathological Conditions, Signs and Symptoms > Pathologic Processes > Arrhythmia
ID Code:165
Deposited By:Indian Pacing and Electrophysiology Journal
Deposited On:04 July 2005

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