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A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation
16:40

A New Single Chamber Implantable Defibrillator with Atrial Sensing: A Practical Demonstration of Sensing and Ease of Implantation

Published on: February 28, 2012

Single-chamber versus dual-chamber implantable cardioverter defibrillators: do we need physiologic pacing in the

Marco Budeus1, Thomas Buck, Heinrich Wieneke

  • 1Department of Cardiology, West-German Heart Centre, University of Duisburg-Essen, Germany. marco.budeus@medizin.uni-essen.de

Indian Pacing and Electrophysiology Journal
|September 1, 2006
PubMed

Insights

Dual-chamber ICD pacing (DDD(R)) significantly improved heart failure symptoms and objective measures compared to single-chamber pacing (VVI(R)). This upgrade reduced ventricular pacing and enhanced patient outcomes, demonstrating DDD(R) superiority.

Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Patients with implantable cardioverter-defibrillators (ICDs) often receive antiarrhythmic drugs for tachycardias.
  • These drugs can lead to AV-block or chronotropic incompetence, increasing ventricular pacing.

Purpose of the Study:

  • To evaluate the impact of upgrading from VVI(R) to DDD(R) pacing mode in patients with ICDs.
  • To assess changes in subjective and objective heart failure parameters.

Main Methods:

  • Retrospective study of 12 patients upgraded from VVI(R) to DDD(R) ICD pacing.
  • Data collected at baseline (VVI(R)) and after 6 and 12 months of DDD(R) pacing.
  • DDD(R) pacing utilized a long AV-interval and AV hysteresis to minimize ventricular pacing.

Main Results:

  • Significant improvements observed in 6-minute walk test, NYHA classification, BNP levels, and left ventricular ejection fraction with DDD(R) pacing.
  • Ventricular pacing decreased from 84.2% to 1.1% after 12 months of DDD(R) pacing.
  • Enhanced atrial contraction contributed to improved hemodynamic parameters.

Conclusions:

  • DDD(R) pacing mode demonstrates superiority over VVI(R) mode in improving subjective and objective parameters in ICD patients.
  • Reduced ventricular pacing through DDD(R) pacing is associated with enhanced cardiac function and patient outcomes.
  • Upgrading to DDD(R) pacing is beneficial for patients experiencing chronotropic incompetence and progressing heart failure.
Abstract

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