Cor Vasa 2010, 52(4):257-261 | DOI: 10.33678/cor.2010.062

Long-term reliability of AAI/R pacing mode in patients with sinus node disease - 10-year experience

Vladimír Ťažký^1,*, Juraj Mistrík²

¹ Cardio Clinic, s. r. o., Bratislava

² Kardiologická ambulancia, Delio, s. r. o., Bratislava, Slovensko

Aim: To find out how much determination of the Wenckebach point (WB) is a reliable method for indicating long-term treatment of patients with sick sinus syndrome (SSS) and AAI/R cardiac pacing. To detect changes in the conduction capacity of the AV node (WB) after pacemaker (PM) implantation. To determine the prevalence of atrial fibrillation, flutter, and other atrial arrhythmias. To identify the need for hospitalization of cardiac patients and the incidence of complications.

Methods: A total of 104 consecutive patients who underwent AAI/R mode PM implantation for symptomatic SSS from March 1996 to December 2006 were studied. The mean age of the remaining 97 patients (62.8% women) was 72.6 years. The length of follow-up was 52.9 ± 26.3 months.

Results: A minimum of AV conduction disturbances occurred in our cohort. The WB in long-term monitoring was substantially unchanged. After 19 months of paroxysmal atrial fibrillation (AF), one patient had re-implantation to VVIR mode outside our department. Later on, we again observed sinus rhythm in this patient. Due to the paroxysmal complete AV block, upgrade to DDD mode was indicated in one case 30 months after PM implant. During the follow-up period, we did not observe any cases of chronic AF. In one case, we observed recurrent paroxysmal AF, successfully managed, dealt with two DC cardioversions within a short time interval. The remaining five cases of paroxysmal AF's were successfully treated with drugs. In all cases, the indicated treatment was effective in preventing relapses into paroxysmal AF. In one case, a short period of atrial flutter for a duration of up to four seconds was detected.

Conclusions: Periprocedural measurement of the WB appears to be an appropriate and sufficient method to indicate permanent AAI/R pacing. Atrial pacing should be used more frequently in sinus node disease.

Keywords: Sick Sinus Syndrome; Atrial Pacing; Pacemaker; Wenckebach Point

Published: April 1, 2010  Show citation