Clinical problems in atrial synchronous ventricular inhibited pacing: a long-term follow-up of 54 patients

Fifty-four VDD-paced patients were followed for more than 12 months; they were studied retrospectively in order to assess possible clinical problems and their management. The patients were between 19 and 84 years of age (mean, 66 +/- 11). Twenty-four of the 54 received a VDD pacemaker as a primary implant and 30 had had VVI pacemakers which were changed to VDD mainly because of limited exercise tolerance or symptoms of AV asynchrony. The follow-up time was between 12 and 69 months (mean, 39 +/- 17). Pacemaker and lead problems were neither frequent nor serious. Six patients had spontaneous paroxysmal supraventricular tachyarrhythmias, four had pacemaker-mediated supraventricular tachycardias and six had ventricular tachyarrhythmias. Treatment of tachyarrhythmias included drugs, DC conversion, reprogramming, or combinations of these measures. Frequency of hospitalization was not greater than expected. In conclusion, VDD pacing appears safe and reliable, with problems mainly associated with the underlying cardiac disease rather than to the pacing mode itself.