DDI pacing: indications, expectations, and follow-up

Area of Science:

• Cardiology
• Biomedical Engineering
• Electrophysiology

Background:

• Dual chamber pacing is crucial for managing bradycardia.
• The DDI pacing mode offers specific advantages for atrioventricular sequential support.
• Patient selection and pacing mode programming are critical for optimal outcomes.

Purpose of the Study:

• To evaluate the efficacy and safety of the DDI pacing mode in patients requiring dual chamber pacing.
• To assess the long-term performance and reprogramming outcomes of DDI pacing.
• To identify potential complications and management strategies associated with DDI pacing.

Main Methods:

• Retrospective analysis of 65 patients programmed to DDI mode between February 1985 and March 1990.
• Utilized Pacesetter 283 or 285 pulse generators programmed to DDI.
• Follow-up included predischarge, 6 weeks, 3 months, and 6 months post-discharge, with a mean follow-up of 31 months.

Main Results:

• 83% of patients remained in the DDI mode throughout the follow-up period.
• Six patients experienced effective VVI pacing due to ventriculoatrial conduction with atrial output inhibition.
• Four patients had functional undersensing, resolved by reprogramming the ventricular blanking period to 13 msec.

Conclusions:

• The DDI pacing mode is a viable option for dual chamber pacing, particularly for patients with sick sinus syndrome and AV block.
• Most patients tolerate DDI pacing well, with a low rate of reprogramming and manageable functional undersensing.
• Careful programming of the ventricular blanking period can effectively address functional undersensing issues in DDI mode.