[Use of dual-chamber pacemaker. Short and long-term results].

BACKGROUND: Continuous improvement of dual chamber DDD pacemakers, electrode stability and programmed sequential stimulation changed the prognosis of patients implanted with these devices. AIM: To report our experience with the use of dual chamber pacemakers. MATERIAL AND METHODS: One hundred seventy six patients (116 male), aged 13 to 91 years old, who received a dual chamber pacemaker implant, are reported. Patients were followed for a mean of 2.6 years. RESULTS: Indications for DDD pacemaker were complete atrioventricular block in 43%, sick sinus syndrome in 32%, paroxysmal A-V block in 24%. All pacemakers were Siemens-Pacesetter and were provided with an automatic sensing and threshold device. J shaped atrium electrodes were used in 78% of patients and screw-in electrodes in 22%. Post operative complications were displacement of atrial electrode in 8 patients, of ventricular electrode in 6 patients, infection in two patients and a hematoma in one. Chronic parameters, measured after six months, were within expected ranges and allowed a good reprogramming of pacemakers. Long term programming aimed to reduce battery depletion, enhance device performance and improve hemodynamic conditions. Normal sequential stimulation was achieved in 154 patients (87%), 14 (85) patients died of cardiovascular disease not related to pacemaker function. Eight patients were in atrial fibrillation and were reprogrammed to VVI and DDI modes. CONCLUSIONS: DDD pacemakers are reliable and afford symptomatic relief in a broad spectrum of patients.