Clinical Significance of Cardiac Permanent Pacemaker Mode Option in Patients with Complete Atrioventricular Block

Abstract

Objective:We assessed the impact of pacing mode on long-term clinical outcomes in cases with the complete atrioventricular block (CAB).Method:We retrospectively analyzed 161 patients with CAB, who undergone a cardiac permanent pacemaker. Of the patients involved in the physiologic pacing (PP) group, 95 patients were with the VDD pacing mode and 14 patients were with the DDD pacing mode. In the ventricular pacing (VP) group, with the VVI pacing mode, there were 52 patients.Results:The average age of the patients was 66±13 years and the average follow-up duration was 40.2±22.6 months. Atrial fibrillation (AF) was observed to be significantly more common in the VP group than in the PP group (p=0.007). However, the occurrence of stroke was similar between the two groups (p=0.753). Newly developed congestive heart failure (CHF) was seen more commonly in the VP group (p=0.015). When we evaluated the patients with and without CHF before pacemaker placement, the number of patients with CHF was reduced in the PP group (p=0.039) and insignificantly increased in the VP group (p=0.219).Conclusion:We conclude that in patients with CAB, the use of PP, compared to VP, may decrease the rate of AF and CHF in the long-term.

Keywords

• artificial cardiac pacing
• atrial fibrillation
• atrioventricular block
• heart failure
• stroke