What does this research mean for the field?

Pacemaker systems incorporating atrial sensing and/or pacing provide acute haemodynamic benefits for patients with sick sinus syndrome and atrioventricular block, although concurrent atrial fibrillation and abnormal sinus node function can limit the broader use of atrial synchrony. Novelty: ClaimNovelty.INCREMENTAL. Consensus alignment: ConsensusAlignment.NEUTRAL.

What question did this study set out to answer?

To establish the electrophysiological and haemodynamic rationale for matching individual conduction disorders to specific pacemaker pacing and sensing configurations.

May 1, 1979HeartOpen Access

Electrophysiological and haemodynamic basis for application of new pacemaker technology in sick sinus syndrome and atrioventricular block.

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Why the study?

Does electrophysiological and haemodynamic evaluation guide the appropriate application of pacemaker systems in patients requiring permanent cardiac pacing?

Key Points

To establish the electrophysiological and haemodynamic rationale for matching individual conduction disorders to specific pacemaker pacing and sensing configurations.
Evaluated 62 consecutive patients presenting over 1 year for permanent cardiac pacing, including 23 with sick sinus syndrome, 38 with atrioventricular block, and 1 with ventricular tachycardia.
Performed electrophysiological and acute haemodynamic testing to determine optimal pacing modes, including atrial, ventricular, and atrioventricular sequential pacing.
Assigned permanent atrial pacing (n=8), ventricular pacing (n=14), or atrioventricular sequential pacing (n=1) for sick sinus syndrome, and atrial synchronous ventricular inhibited (n=8) or ventricular pacing (n=30) for atrioventricular block.
Identified atrial fibrillation (n=9) and abnormal sinus node function (n=15) as primary limiting factors that prevented the broader adoption of atrial synchronous pacing.
Demonstrated qualitative acute haemodynamic benefits when using pacing systems that incorporate atrial sensing, atrial pacing, or dual-chamber coordination.

Structured PICO

Does electrophysiological and haemodynamic evaluation guide the appropriate application of pacemaker systems in patients requiring permanent cardiac pacing?

Population

62 consecutive patients presenting over a period of 1 year for permanent cardiac pacing (23 with sick sinus syndrome, 38 with atrioventricular block, and 1 with ventricular tachycardia).

Intervention

Application of pacemaker systems (atrial pacing, ventricular pacing, atrioventricular sequential pacing, or atrial synchronous ventricular inhibited pacing) guided by electrophysiological and haemodynamic studies.

Outcome

Acute haemodynamic benefit and appropriate application of pacemaker systems.surrogate

Electrophysiological and haemodynamic evaluation can guide the optimal selection of pacemaker systems, demonstrating acute haemodynamic benefits of atrial sensing and pacing in eligible patients.

Discussion

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Implication

Should not change pacemaker selection; leaves open prospective evaluation of atrial synchrony in patients without AF or SND.

Cite This Study

Sutton et al. (1979) studied this question.

synapsesocial.com/papers/6a1d221fba65f5ee325ddc73 https://doi.org/10.1136/hrt.41.5.600

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Electrophysiological and haemodynamic basis for application of new pacemaker technology in sick sinus syndrome and atrioventricular block.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Electrophysiological and haemodynamic basis for application of new pacemaker technology in sick sinus syndrome and atrioventricular block.

Key Points

Structured PICO

Discussion

Implication

Cite This Study

Also Consider

Also Consider