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Clinical experience with permanent atrioventricular sequential pacing

J J Curtis, N P Madigan, R B Whiting

    The Annals of Thoracic Surgery
    |August 1, 1981
    PubMed
    Summary
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    Atrioventricular (AV) sequential pacing significantly improved cardiac index by 22% compared to ventricular pacing in patients with heart block or sick sinus syndrome. This study confirms the hemodynamic benefits of AV sequential pacing.

    Area of Science:

    • Cardiology
    • Biomedical Engineering

    Background:

    • Atrioventricular (AV) sequential pacing aims to restore normal cardiac rhythm and improve hemodynamics.
    • Indications for pacing included complete heart block and sick sinus syndrome.

    Purpose of the Study:

    • To evaluate the hemodynamic efficacy of AV sequential pacing.
    • To assess complications associated with AV sequential pacing.

    Main Methods:

    • Implantation of 26 permanent AV sequential pacing units in 26 patients (11 women, 15 men; age 37-85 years).
    • Cardiac index determination using thermodilution during ventricular pacing and AV sequential pacing at a constant heart rate in 9 patients.

    Main Results:

    • AV sequential pacing demonstrated a mean increase in cardiac index of 22% (p<0.01) compared to ventricular pacing.

    Related Experiment Videos

  • Complications included pulse generator pocket revisions and one atrial lead displacement.
  • No pacing or sensing failures occurred over 279 patient-paced months.

    • Conclusions:

    • AV sequential pacing offers a significant hemodynamic advantage over ventricular pacing.
    • Improvements in pulse generator design and electrode placement can mitigate complications.