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November 1, 1992Pacing and Clinical Electrophysiology

Atrioventricular Conduction Disturbances in Patients with Sinoatrial Node Disease and Atrial Pacing

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Key result

AAI pacing leads to symptomatic AV conduction disturbances requiring mode change in ~6% of patients.

  • n=122

Why the study?

The incidence and characteristics of AV conduction disturbances requiring pacing mode change after AAI pacemaker implantation in patients with sinoatrial node disease were not well defined.

Population

122 patients with sinoatrial node disease (37 sinus bradycardia, 85 bradycardia-tachycardia syndrome), mean age 63 years

Comparison

AAI pacing before and after development of AV conduction disturbances

Design

Retrospective cohort study

Follow-up

5 to 83 months (mean 35 months)

Authors

GŜGRAŻYNA ŜWIĄTECKASemmelweis UniversitySSSławomir SielskiNicolaus Copernicus UniversityRWRajmund WilczekState University of Applied Sciences in Elbląg

Discussion

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Implication

May support AAI pacing in selected patients; leaves open need for randomized confirmation.

Key Points

  • To evaluate the incidence and characteristics of atrioventricular conduction disturbances that necessitate a change in pacing mode among patients with atrial pacemakers.
  • Retrospective cohort analysis of N=122 patients (mean age 63 years; 37 with sinus bradycardia, 85 with bradycardia-tachycardia syndrome) implanted with AAI pacing systems.
  • Patients had normal baseline atrioventricular conduction on 12-lead ECG and were monitored over a follow-up period ranging from 5 to 83 months (mean: 35 months).
  • Symptomatic atrioventricular conduction disturbances occurred in 7 of 122 patients (5.7%), requiring conversion from AAI to an alternative pacing mode.
  • Observed conduction failures included second-degree type I atrioventricular block in 5 patients, second-degree type II block in 1 patient, and third-degree block in 1 patient.

Study Design

Type

Cohort (n=122)

Structured PICO

P
Population
122 patients (mean age 63) with sinoatrial node disease and normal baseline AV conduction who received AAI pacemakers, followed for a mean of 35 months.
E
Exposure
AAI pacemaker implantation
O
Outcome
Development of symptomatic AV conduction disturbances necessitating a change from AAI to another mode of pacingsafety

Progression of AV block after AAI pacemaker implantation in patients with sinoatrial node disease is infrequent (5.7%), suggesting AAI pacing is generally safe in appropriately selected patients.

Cite This Study

ŜWIĄTECKA et al. (1992) conducted a cohort in Sinoatrial node disease (n=122). AAI pacing was evaluated on Symptomatic conduction disturbances necessitating a change from AAI to another mode of pacing. AAI pacing in patients with sinoatrial node disease resulted in symptomatic AV conduction disturbances requiring a pacing mode change in 5.7% of patients over a mean follow-up of 35 months.

synapsesocial.com/papers/6aadea8384a76b509095a7f3https://doi.org/10.1111/j.1540-8159.1992.tb03024.x
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1The Natural History of Sick Sinus Syndrome1986 · 288 citations
  2. 2Transesophageal Programmed Atrial Pacing as a Method of Selecting Patients with Sick Sinus Syndrome for Permanent Atrial Pacing1988 · 3 citations
  3. 3Atrioventricular Conduction Defects in Patients with Sinus Bradycardia1971 · 159 citations
  4. 4Sick Sinus Syndrome Treated with Permanent Pacemaker in 109 Patients1979 · 73 citations
  5. 5Electrophysiologic Evaluation of Elderly Patients with Sinus Bradycardia1979 · 159 citations