Key result
SafeR pacemaker programming is linked to ~24 months greater device longevity compared to DDD mode.
Why the study?
Battery longevity of dual-chamber pacemakers is a critical clinical concern, and the impact of device settings and reprogramming on expected longevity requires further description.
Observational (n=1,068)
Yes
Mean Difference: 23.9
p-value: p=<0.0001
Optimizing mode and outputs may extend dual-chamber pacemaker longevity; supports prospective trials of reprogramming strategies.
BACKGROUND: This study aimed to describe the influence on dual-chamber devices' expected longevity of devices' settings. METHODS: Data from patients implanted with dual chamber devices (Symphony™, SORIN CRM SAS, Clamart, France) from 2003 to 2006 were collected in registries. Programmer files were retrieved: device-estimated longevity, assessed through algorithm prediction, was analyzed according to device settings. RESULTS: One thousand sixty-eight recipients of dual chamber pacemaker in sinus rhythm (75.3±11.1 years, 54.5% male, ventricular block 30%, brady-tachy syndrome 21%, and sinus node dysfunction 49%) were followed up to 14.2±12.1 months (ranging from first quartile Q1: 2.9 months to fourth quartile Q4: 49.3 months) after implantation. DDD with automatic mode conversion and minimized ventricular pacing (SafeR) modes were programmed in 34.3%, 2.9%, and 62.8% of the patients, respectively. The mean total longevity estimated by the device was 134.1±31.5 months (11.2±2.6 years). Significant increase in longevity was observed in devices undergoing at least one reprogramming (134.4±31.4 months) versus device presenting no reprogramming (103.4±32.3 months, P=0.0005). The parameters associated with the major increase in mean longevity were the mode (mean longevity increase of +23.9 months in SafeR as compared to DDD mode, P<0.0001) and the atrial (A) and ventricular (V) amplitudes (mean longevity increase of +29.6 and +26.9 months for a decrease of less than 1V in A and V outputs respectively, P<0.0001). CONCLUSION: This study provides information on dual chamber pacemakers' longevity and highlights the impact of devices' reprogramming on expected longevities.
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Benkemoun et al. (2012) conducted an observational in Patients in sinus rhythm requiring dual chamber pacemakers (n=1,068). Pacemaker reprogramming (SafeR mode and output reduction) vs. No reprogramming (DDD mode) was evaluated on Device-estimated longevity (MD 23.9 months, p=<0.0001). Programming dual-chamber pacemakers to SafeR mode instead of DDD mode significantly increased device-estimated longevity (mean increase of +23.9 months, P<0.0001).
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