Key result
Low Wenckebach block rate in AAI pacing shows similar AV conduction disturbance risk to high rates.
Why the study?
Does a low Wenckebach block rate increase the risk of atrioventricular conduction disturbance in patients with sinus node dysfunction on AAI pacing compared to a high Wenckebach block rate?
Cohort (n=102)
Does a low Wenckebach block rate increase the risk of atrioventricular conduction disturbance in patients with sinus node dysfunction on AAI pacing compared to a high Wenckebach block rate?
The long-term risk of developing AV conduction disturbance is low in patients with sinus node dysfunction on AAI pacing, even if they have a low Wenckebach block rate of 100 to 129 per minute.
Answers are grounded in this paper and cite their sources.
May support lower Wenckebach thresholds for AAI pacing in sinus node dysfunction; leaves open prospective validation of AV conduction risk.
AIMS: To compare the risk of atrioventricular (AV) conduction disturbance between patients with sinus node dysfunction on AAI pacing who had a low or high Wenckebach block rate (WBR). METHODS AND RESULTS: Patients with sinus node dysfunction and normal AV conduction those underwent an electrophysiological study were studied. The patients were classified into two groups: Group L was with the patients with a WBR of 100 to 129 per minute and Group H was with the patients with a WBR > or = 130 per minute. All patients followed up every 3-6 months after an AAI pacemaker implantation. A total of 102 patients, including 35 Group L and 67 Group H, were followed for 90 +/- 44 months. Six patients died from non-cardiac cause and five patients required a new atrial lead implantation due to lead failure during follow-up. Symptomatic bradycardia requiring a new ventricular lead implantation developed in four patients (annual incidence 0.5%). In Group L, two patients developed AV block (annual incidence 0.7%). In Group H, two patients developed bradycardic atrial fibrillation (annual incidence 0.4%). Kaplan-Meier analysis revealed no significant difference between the two groups (P = 0.2983). CONCLUSION: These results suggest that a long-term risk of developing AV conduction disturbance is low even in patients with a WBR of 100 to 129 per minute.
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Adachi et al. (2008) conducted a cohort in Sinus node dysfunction (n=102). Low Wenckebach block rate (100-129 per minute) vs. High Wenckebach block rate (≥ 130 per minute) was evaluated on AV conduction disturbance or symptomatic bradycardia requiring a new ventricular lead implantation (p=0.2983). A low Wenckebach block rate (100-129 bpm) in patients with sinus node dysfunction on AAI pacing was associated with a low long-term risk of AV conduction disturbance, similar to a high rate (P=0.2983).
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