Key result
VVIR pacing in cardiac transplant recipients resulted in VA conduction in 100% and pacemaker syndrome in 50% of patients, whereas DDDR pacing was technically feasible and preferable.
Why the study?
Does DDDR pacing improve clinical outcomes and prevent pacemaker syndrome compared to VVIR pacing in cardiac transplant recipients?
Cohort (n=9)
Does DDDR pacing improve clinical outcomes and prevent pacemaker syndrome compared to VVIR pacing in cardiac transplant recipients?
Dual chamber (DDDR) pacing is technically feasible and preferable to single chamber (VVIR) pacing following cardiac transplantation to avoid VA conduction and pacemaker syndrome.
Answers are grounded in this paper and cite their sources.
May support DDDR over VVIR to avoid pacemaker syndrome post-transplant; hypothesis-generating pending randomized confirmation.
UNLABELLED: We compared the clinical course of patients paced in VVIR versus DDDR mode to determine the most appropriate method of pacing following cardiac transplantation. Pacemaker implantation was required in 9 of 90 orthotopic cardiac transplants (10%). Indications included sinus bradycardia or sinus arrest (8 patients) and AV node dysfunction (1 patient). VVIR pacemakers were implanted in four patients and DDDR in five patients. DDDR patients: The mean P wave was 1.7 mV and the mean atrial stimulation threshold was 0.8 V (at 0.5 msec). During follow-up of 20 months, two atrial lead complications developed (29% of leads in 33% of patients). No lead complications were directly related to endomyocardial biopsy. VVIR patients: All four patients developed VA conduction with mean VA time 180 msec (160-240 msec). Two patients developed pacemaker syndrome. CONCLUSIONS: VA conduction and pacemaker syndrome may develop in cardiac transplant recipients paced in the VVIR mode. Dual chamber pacing is technically feasible and preferable following cardiac transplantation.
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Roelke et al. (1994) conducted a cohort in Cardiac transplantation requiring pacemaker implantation (n=9). DDDR pacing vs. VVIR pacing was evaluated on Clinical course including VA conduction, pacemaker syndrome, and lead complications. VVIR pacing in cardiac transplant recipients resulted in VA conduction in 100% and pacemaker syndrome in 50% of patients, whereas DDDR pacing was technically feasible and preferable.
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