Related Experiment Video

Updated: Jun 13, 2025

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

26.2K

Dual-chamber vs. single-chamber pacemaker in patients in sinus rhythm with an atrioventricular block: a nationwide

Alexandre Bodin1, Ivann Texier1, Arnaud Bisson1

  • 1Service de Cardiologie, Centre Hospitalier Universitaire Trousseau, Faculté de Médecine, Université François Rabelais, 37000 Tours, France.

Europace : European Pacing, Arrhythmias, and Cardiac Electrophysiology : Journal of the Working Groups on Cardiac Pacing, Arrhythmias, and Cardiac Cellular Electrophysiology of the European Society of Cardiology
|September 13, 2024
PubMed

Insights

Dual-chamber pacemakers significantly reduce mortality and adverse events in patients with complete atrioventricular block and sinus rhythm compared to single-chamber devices. This study supports current guidelines favoring dual-chamber pacemaker implantation for improved patient outcomes.

Area of Science:

  • Cardiology
  • Medical Devices
  • Clinical Research

Background:

  • Complete atrioventricular block (AVB) with sinus rhythm often necessitates pacemaker implantation.
  • Current guidelines recommend dual-chamber pacemakers over single-chamber ones, but robust evidence on hard clinical outcomes is limited.

Purpose of the Study:

  • To evaluate the long-term clinical effectiveness and safety of dual-chamber versus single-chamber pacemakers in patients with complete AVB and underlying sinus rhythm.

Main Methods:

  • Retrospective observational study using a French national administrative database (2013-2022).
  • Inclusion of patients with primary pacemaker implantation for complete AVB and sinus rhythm.
  • Propensity score matching to create comparable groups of dual-chamber and single-chamber pacemaker recipients (19,219 patients each).

Main Results:

  • Dual-chamber pacemakers were associated with significantly lower all-cause mortality (9.22%/year vs 11.48%/year; HR 0.807) and cardiovascular mortality (HR 0.766).
  • Reduced incidence of heart failure (HR 0.908), atrial fibrillation (HR 0.778), and ischemic stroke (HR 0.873) observed in the dual-chamber group.
  • Fewer re-interventions (upgrades) but more hematomas and lead repositioning noted with dual-chamber devices.

Conclusions:

  • Findings support current recommendations for dual-chamber pacemaker preference in complete AVB with sinus rhythm.
  • Dual-chamber pacemaker implantation is linked to reduced risks of mortality, heart failure, atrial fibrillation, and stroke.
  • The benefits of dual-chamber pacing outweigh potential complications in this patient population.
Abstract

Keywords:
Atrioventricular blockCardiac pacing

More Related Videos

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China08:42

Cox-Maze IV Procedure Concomitant with Valvular Surgery In Situs Inversus Dextrocardia: A Single-Center Experience in China

Published on: February 11, 2022

3.4K
Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice08:05

Optimization of Transesophageal Atrial Pacing to Assess Atrial Fibrillation Susceptibility in Mice

Published on: June 29, 2022

2.7K

Related Concept Videos

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers01:22

Antiarrhythmic Drugs: Class I Agents as Sodium Channel Blockers

Class I antiarrhythmic drugs are used to treat various types of arrhythmias or irregular heart rhythms. These drugs block the sodium (Na+) channels in the cardiac cells, thereby affecting the movement of electrical impulses across the heart. Class I antiarrhythmic drugs are divided into three subgroups: Class IA, Class IB, and Class IC, each with distinct mechanisms of action and effects on the heart.
Class 1A Antiarrhythmic Drugs: These drugs work by moderately blocking sodium channels,...
1.3K
Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers01:24

Antiarrhythmic Drugs: Class II Agents as β-Adrenergic Blockers

Adrenergic stimulation generally impacts cardiac rate and rhythm. Specifically, stimulation of the β-adrenoceptors triggers an increase in intracellular calcium ion influx and pacemaker currents, which may cause arrhythmias. Catecholamines like adrenaline also demonstrate β2-adrenoceptor-mediated hypokalemia, impacting cardiac action potential and disrupting the normal cardiac rhythm. Class II antiarrhythmic drugs are β-adrenoceptor antagonists or β-blockers, which...
719
Electrophysiology of Normal Cardiac Rhythm01:19

Electrophysiology of Normal Cardiac Rhythm

The normal cardiac rhythm is a synchronized electrical activity that facilitates the regular and coordinated contraction of the heart muscle. This process is essential for efficient blood circulation throughout the body. The fundamental elements involved in establishing and maintaining this rhythm include the unique electrical properties of cardiac muscle cells, the sinoatrial (SA) node's pacemaker function, the specialized conducting system, and the ionic mechanisms underlying each phase...
2.3K