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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing
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Benefits of Cardiac Resynchronization Therapy in an Asynchronous Heart Failure Model Induced by Left Bundle Branch Ablation and Rapid Pacing

Published on: December 11, 2017

Long-term survival of VDD pacing

R Chamberlain-Webber1, E Barnes, M Papouchado

  • 1Cardiology Department, Bristol Royal Infirmary, United Kingdom. mdrxcw@bristol.ac.uk

Pacing and Clinical Electrophysiology : PACE
|November 24, 1998
PubMed

Insights

Reprogramming VDD pacing systems is uncommon, typically due to atrial arrhythmias or sensing issues. VDD pacing is a viable long-term alternative to DDD pacing when atrial chronotropy is adequate.

Area of Science:

  • Cardiology
  • Biomedical Engineering

Background:

  • Ventricular-inhibited, Atrial-inhibited, and Dual-chamber pacing (DDD) systems are common for bradycardia.
  • Ventricular-inhibited, Dual-chamber, Pacing (VDD) systems offer an alternative, but their long-term performance and reprogramming needs require evaluation.

Purpose of the Study:

  • To assess the frequency and reasons for reprogramming VDD pacing systems.
  • To compare patient characteristics and outcomes between VDD systems that required reprogramming and those that did not.

Main Methods:

  • Retrospective analysis of patients with VDD systems implanted at a tertiary pacing center.
  • Data collected included pacing indications, follow-up duration, rate response settings, reasons for programming changes, and implant P wave amplitudes.
  • Patients were categorized into those with no mode change (NMC) and those with mode change (MC) during follow-up.

Main Results:

  • 335 VDD leads in 316 patients were analyzed with a mean follow-up of 24.1 months.
  • Reprogramming (MC group, n=36) was infrequent, primarily due to atrial arrhythmias (e.g., AF/atrial flutter) or atrial sensing issues.
  • MC patients were significantly more likely to have rate response programmed ON (44.4% vs. 22.1%).

Conclusions:

  • Reprogramming of VDD systems is infrequent and usually driven by atrial arrhythmias or sensing failures.
  • When atrial chronotropy is adequate, VDD pacing is a suitable long-term alternative to DDD pacing.
  • VDD systems demonstrate good long-term survival and performance.
Abstract

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