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[The DDD pacemaker implanted intravenously]
V Araya Gómez1, L López Barreiro, J A González-Hermosillo
1Departamento de Electrofisiología Clínica, Instituto Nacional de Cardiología Ignacio Chávez, México, D.F.
Archivos Del Instituto De Cardiologia De Mexico
|March 1, 1995
Summary
Dual chamber (DDD) pacemakers are effective for heart rhythm issues like AV block. However, implantation requires expertise, and 17% of patients experienced complications, often necessitating pacing mode changes.
Area of Science:
- Cardiology
- Biomedical Engineering
Background:
- Dual chamber pacing (DDD) is a common therapy for bradyarrhythmias.
- Understanding implantation techniques and complication rates is crucial for patient outcomes.
Purpose of the Study:
- To evaluate the outcomes and complications of intravenous DDD pacemaker implantation.
- To identify factors associated with complications in DDD pacemaker recipients.
Main Methods:
- Retrospective study of 66 patients receiving DDD pacemakers.
- Analysis of implantation routes (subclavian punction vs. cephalic vein dissection).
- Assessment of complications, pacing parameters, and follow-up data over a mean of 16 months.
Main Results:
- 17% of patients experienced complications, with 9 requiring a change in pacing mode.
- Complications included loss of atrial/ventricular capture, pacemaker-mediated tachycardia, infection, and atrial fibrillation.
- Lower P wave amplitude and higher atrial pacing thresholds at implantation were associated with higher complication rates (p < 0.005).
Conclusions:
- DDD pacing is a well-established therapy but demands meticulous implantation and specialized follow-up.
- Pre-implantation pacing parameters may predict the risk of complications.
- Optimizing implantation techniques and patient selection can potentially reduce adverse events.