[Results of single head VDD-stimulation]

Area of Science:

• Cardiology
• Biomedical Engineering
• Medical Devices

Context:

• High-degree atrioventricular (AV) block with preserved sinus node function necessitates pacing.
• Ventricular-demand (VDD) pacing systems offer a single-lead solution for AV synchronous stimulation.
• Comparison with dual-chamber (DDD) pacing systems is crucial for clinical decision-making.

Purpose:

• To present current results of VDD pacing regarding implantation, atrial sensing, AV synchrony, and sinus node function.
• To compare VDD system performance with DDD systems.
• To discuss ventricular lead performance, cost-effectiveness, and emerging single-lead DDD technologies.

Summary:

• VDD systems demonstrate shorter implantation times (up to 40%) and reduced fluoroscopy (up to 55%) compared to DDD systems, with a trend towards fewer perioperative complications.
• P-wave sensing reliability and AV synchrony are comparable between VDD and DDD systems (≥99%).
• Sinus node disease requiring atrial pacing occurs in 1-2% of patients, making the absence of atrial pacing in VDD systems generally inconsequential. Ventricular lead function is similar, and VDD systems offer cost advantages.

Impact:

• VDD pacing systems are established and effective for isolated high-degree AV block.
• VDD systems demonstrate comparable efficacy to DDD systems and offer advantages in implantation efficiency, cost, and potentially fewer complications.
• The findings support VDD systems as a valuable therapeutic option, with ongoing developments in single-lead pacing technologies.