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Pacemaker programming in patients with first-degree AV-block: Programming pattern and possible consequences.

F Holmqvist1,2, B Rathakrishnan3, L R Jackson1

  • 1Clinical Cardiac Electrophysiology Duke University Medical Center Durham NC USA.

Health Science Reports
|January 10, 2019
PubMed
Summary
This summary is machine-generated.

In patients with first-degree AV-block, pacemaker programming choice varied, with most opting for atrial pacing. This decision impacts long-term pacing burden and patient outcomes.

Keywords:
first‐degree AV‐blockpacemaker programmingsinus node dysfunction

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Devices

Background:

  • Optimal pacemaker pacing strategies for patients with first-degree atrioventricular (AV)-block remain undefined.
  • Current guidelines lack specific recommendations for pacing mode selection in this patient population.

Purpose of the Study:

  • To investigate current pacemaker programming practices in patients with first-degree AV-block and dual-chamber pacemakers.
  • To explore the relationship between patient characteristics and programmed pacing modes.

Main Methods:

  • Retrospective chart review of 74 patients with sinus node dysfunction and first-degree AV-block at Duke University Hospital.
  • Analysis of baseline demographics, pacemaker programming parameters, and follow-up data.
  • Evaluation of pre- and post-implantation electrocardiograms.

Main Results:

  • The majority of patients (65%) were programmed for atrial pacing (AAI/DDD +/-R), while 32% received AV-sequential pacing (DDD) and 2.7% ventricular pacing (VVI).
  • No significant differences in baseline characteristics were found across the three pacing modes.
  • Patients programmed to AAI mode showed a significantly lower percentage of ventricular pacing at follow-up compared to DDD and VVI modes.

Conclusions:

  • Pacemaker programming mode choice in patients with first-degree AV-block is not clearly associated with baseline characteristics.
  • The selected pacing mode significantly influences the long-term pacing burden.
  • Pacing burden is a known factor affecting patient outcomes.