Indications for permanent pacing and pacing mode prescription from 1989 to 2006. Experience of a single academic centre in Northern Greece.

Objective To compare the incidence of atrial fibrillation (Af) in the first 5 years after implantation of single chamber ventricular pacing (VVI) or atrial pacing (AP,including AAI and DDD pacing) in the patients with sick sinus syndrome (SSS).Methods 117 cases of SSS patients who had accepted permanent pacing treatment and were continually follow up surveyed for at least 5 years were selected.Follow up surveying was carried out in 83 cases of VVI pacing and in 34 cases of AP pacing by clinical examination,electrocardiography,DCG and pacing parameter measurements.To analyse the incidence of Af in the two groups.Results The total incidence of permanent Af in the first five years after implantation of pacemaker was 17.09% (20/117).The incidence of permanent Af after VVI pacemaker implantation was 22.89% (19/83),the incidence of permanent Af after AP was only 2.94% (1/34); there was a marked significance between VVI pacing and AP pacing (P0.01).Conclusion Among SSS patients treated with pacemaker implantation for at least 5 years,compared the patients with VVI pacing,the patients with atrial pacing had a lower incidence of atrial fibrillation.

Sick sinus syndrome

SSS*

Ventricular pacing

Cardiac Pacing

Artificial cardiac pacemaker

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Permanent Cardiac Pacemaker in Infants and Children*

The Thoracic and Cardiovascular Surgeon (1986)

Himansu K. Dasmahapatra Michael Jamieson G M Brewster Bérninzon Doig James Pollock

Between October 1970 and November 1984, 26 infants and children aged 11 days to 18 years (mean 5.7 years) received 42 permanent cardiac pacemakers (26 primary implants, 16 re-implants) for congenital or surgically acquired heart block, bradycardia and sinus node dysfunction. Twenty-two patients had unipolar pacing and 4 bipolar pacing. Of 26 primary implantations, 2 had fixed rate epicardial pacing, 16 ventricular demand pacing (13 epicardial, 3 endocardial), 3 epicardial VAT (P-synchronous) pacing and 5 DDD (universal) pacing (4 epicardial, one endocardial). Fourteen patients required a further 19 operations for change of generators (16), ventricular lead (1), generator site (1) and generator encasing (1).

Cardiac Pacing

Permanent pacemaker

Sinus bradycardia

Sick sinus syndrome

Ventricular pacing

10.1055/s-2007-1020418

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Clinical Experience with Permanent Atrioventricular Sequential Pacing

The Annals of Thoracic Surgery (1981)

Jack J. Curtis Niall P. Madigan Richard B. Whiting Karl Mueller A. Thomas Pezzella

Sick sinus syndrome

Atrioventricular block

Cardiac Pacing

Cardiac index

10.1016/s0003-4975(10)61028-4

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Citations (25)

AAI pacing for sick sinus syndrome: first choice on all counts

Heart (1998)

Howard Marshall Michael D. Gammage Michael Griffith

The British Pacing and Electrophysiology Group guidelines for pacemaker prescription recommend single chamber atrial pacing as the most appropriate pacing mode for sinus node disease in the absence of atrioventricular conduction disturbance.1 As such it offers a rare combination of maximum clinical effectiveness for the minimum cost and a good training opportunity. However, it seems that this message has yet to be translated into pacing practice in the UK. In this issue of Heart , Clarke et al retrospectively analyses the pacing activity for sinus node disease in a tertiary pacing centre over five years.2 They conclude that in their centre £103 000 per year could have been saved by more judicious use of AAI pacing, largely by reducing the DDD implant rate. It seems likely that these potential savings are equally applicable to the rest of the UK. Current pacemaker prescribing for sinus node disease is frequently illogical, ignores current evidence, and misses out on training opportunities for junior staff. The evidence to support atrial based pacing for sinus node disease, rather than single chamber ventricular pacing, is very strong. Numerous retrospective studies have demonstrated that mortality and morbidity are greater in ventricular only paced patients,3-5 and that the progression to chronic atrial fibrillation (AF) is less common in patients with atrial based pacing.3-10 Although these data may be criticised for the potential biases inherent in retrospective studies, since 1994 data have been available from the first prospective randomised study.11 Andersen et al were able to demonstrate a reduction in the frequency of AF and incidence of thromboembolism (5% v 18%) with atrial pacing after three years of follow up. The most recent analysis of this study (at 5.5 years of follow up) has also shown a significant reduction in all cause mortality (35.5% v …

Sick sinus syndrome

Cardiac Pacing

10.1136/hrt.80.4.315

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Clinical analysis of 24 cases of implantation cardiac pacemaker

Sichuan Medical Journal (2008)

Wang Tin

Objective To explore the relation between the various ways of pacing and the pacing syndrome through clinical analysis of cardiac pacemaker datas.Methods VVI had 15 cases and DDD had 9cases among 24 cases of cardiac pacemaker.All cases applieds electrocardio-monitoring after operation and observed clincical symptom of patientes.Results The pacemaker of VVI happened 4 cases of the pacing syndrome,DDD was no cases.Conclusion The pacing syndrome occurrence lower incidence rate in pacing way of DDD than VVI.

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Clinical Experience of Permanent Cardiac Pacemaker Implanted in Elderly Patients

Ye Yang

Objective To analyse the clinical characteristics of elderly patients with permanent cardiac pacemaker implanted.Methods Pacemakers were implanted in 62 cases of elderly patients,aged 80-92 years old,with an average of 85.1 ± 4.2 years old.The type of arrhythmia,pacing mode,pacing intraoperative parameters,intraoperative and postoperative complications were observed.Results All operations were successfully completed,and the pacing modes were,VVI 48 cases,DDD 12 case and DDDR 2 cases.One case of postoperative dislocation electrode,one case of pocket hematocele,and three cases of pacemaker syndrome were observed.The symptoms were significantly improved by decreasing the pacing frequency of treatment.Conclusion Pacing therapy in elderly patients is safe and effective,the pacing parameters and the incidence of postoperative complications are as usual.The elderly patients often encounter difficulties in installing permanent pacemaker catheter and in pacing electrodes fixation.For existing cardiac dysfunction and/or slow-quick syndrome,patients after installation of pacemaker can accept digitalis treatment to improve heart function.

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Artificial cardiac pacemaker

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