Long-Term Comparison of Single-Lead VDD Pacing with Dual-Lead DDD Pacing in Patients with AV Block

Summary Single-lead VDD pacemakers have proven to be a safe and reliable alternative to dual-lead DDD pacemakers in the treatment of atrioventricular block with normal sinus rhythm. This prospective, randomized, multicenter VDD vs. DDD study investigated the long-term safety and reliability of single-lead VDD therapy in comparison to dual- lead systems. Between November 1995 and June 1998, a total of 264 patients with high-degree atrioventricular block and normal sinus function were divided into three groups: group A with a dual-lead DDD pacemaker (90 patients), group B with a dual-lead VDD pacemaker (84 patients), and group C with a single-lead VDD pace- maker (90 patients). The patient characteristics collected before implantation showed a homogenous distribution between the three groups. The sex, age, weight, height, body mass index (BMI), right and left atrial diameter, and ejection fraction (number of patients with normal ejection fraction > 55% and mean ejection fraction < normal) parameters were comparable in all three groups. The indication also showed similar distributions in the symptom and etiology categories, as well as similar medication administration at study inclusion. Lead complications (over- sensing, undersensing, dislocation) were similar in all study groups. There was no indication of sinus node dys- function in need of pacing during the follow-up of group C (SL-VDD). SL-VDD pacing is thus shown to be a viable long-term alternative for the treatment of AV block with normal sinus node function.