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Related Concept Videos

ECG Interpretation of Arrhythmias I: Sinus Arrhythmias01:16

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Arrhythmias are disturbances in the heart's rhythm that lead to abnormal heartbeats. These irregularities can originate from different parts of the heart and are classified based on their origin and nature.
Types of Arrhythmias
Sinus Node Arrhythmias
Sinus Bradycardia: Originating from the sinoatrial (SA) node, sinus bradycardia involves slower impulses, resulting in a heart rate of less than 60 beats per minute (bpm). Causes include sleep, vagal stimulation, beta-blockers, hypothyroidism,...
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Conduction System of the Heart01:19

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Autorhythmicity is a term that refers to the heart's inherent ability to generate electrical signals and instigate muscle contractions. This self-regulating conduction system within the heart consists of two key components: the pacemaker cells and specialized conducting cells.
The pacemaker cells are located in two primary nodes: the sinoatrial (SA) node and the atrioventricular (AV) node. The SA node pacemaker cells can autonomously depolarize, triggering an action potential that leads to the...
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Updated: Jul 9, 2025

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China
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Pacing mode survival in patients with single chamber atrial pacemaker for sinus node dysfunction.

Ramanathan Velayuthan1, Suresh Kumar Sukumar1, Dinakar Bootla1

  • 1Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.

Indian Heart Journal
|December 9, 2023
PubMed
Summary

Single chamber atrial pacing is safe and effective for sinus node dysfunction patients with normal AV conduction. This approach avoids unnecessary dual chamber pacemaker implants, showing rare development of conduction abnormalities.

Keywords:
AAIAV blockAtrial fibrillationDDDSinus node dysfunction

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Area of Science:

  • Cardiology
  • Electrophysiology
  • Medical Device Technology

Background:

  • Sinus node dysfunction (SND) with normal atrioventricular (AV) conduction typically warrants single chamber atrial pacing.
  • Dual chamber pacemaker implantation is often chosen due to concerns about new-onset AV block, with reported incidences ranging from 0.6% to 4.4%.

Purpose of the Study:

  • To evaluate the long-term outcomes of single chamber atrial pacing (AAIR) in patients with SND and normal AV conduction.
  • To assess the incidence of pacemaker device changes, AV block, bundle branch block, atrial fibrillation, lead complications, reoperations, and mortality.

Main Methods:

  • A retrospective analysis of 113 patients with SND and normal AV conduction who received single chamber atrial pacemakers between January 2014 and December 2021.
  • Follow-up included monitoring for pacemaker device changes, new AV block, bundle branch block, atrial fibrillation, lead issues, reoperations, and mortality.

Main Results:

  • None of the 113 patients required a pacemaker device upgrade to VVIR/DDDR during a mean follow-up of 48.7 months.
  • Nine patients (8%) required reoperation for reasons including lead dislodgement, high pacing threshold, pocket erosion, and pulse generator issues.
  • No patients developed new-onset AV block or atrial fibrillation with a slow ventricular rate; only 4 patients (3.5%) developed atrial fibrillation.

Conclusions:

  • Single chamber atrial pacing is a viable and safe option for patients with SND and normal AV conduction, particularly in younger populations.
  • The risk of developing AV conduction abnormalities is low in this patient group, challenging the routine use of dual chamber pacemakers.