Long-Term Complication Rates in Ventricular, Single Lead VDD, and Dual Chamber Pacing

A higher incidence of pacemaker related complications has been reported in DDD systems as compared to VVI devices. The implantation of single lead VDD pacemakers might reduce the complication rate of physiological pacing in patients with AV block. In a retrospective study, the data records of 1,214...

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Bibliographic Details
Published in:	Pacing and clinical electrophysiology Vol. 26; no. 10; pp. 1961 - 1969
Main Authors:	WIEGAND, UWE K.H., BODE, FRANK, BONNEMEIER, HENDRIK, EBERHARD, FRANK, SCHLEI, MONIKA, PETERS, WERNER
Format:	Journal Article
Language:	English
Published:	350 Main Street , Malden , MA 02148-5018 , USA , and 9600 Garsington Road , Oxford OX4 2DQ , UK Blackwell Futura Publishing, Inc 01-10-2003
Subjects:	Adolescent Adult Aged Aged, 80 and over Analysis of Variance Chi-Square Distribution complications dual chamber pacing Female Fluoroscopy Heart Block - therapy Humans Incidence Male Middle Aged Pacemaker, Artificial - adverse effects Proportional Hazards Models Retrospective Studies single lead VDD pacing Time Factors ventricular pacing
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Summary:	A higher incidence of pacemaker related complications has been reported in DDD systems as compared to VVI devices. The implantation of single lead VDD pacemakers might reduce the complication rate of physiological pacing in patients with AV block. In a retrospective study, the data records of 1,214 consecutive patients with pacemaker implantation for AV block between 1990 and 2001 (VVI 36.5%, DDD 32.9%, VDD 30.6%) were analyzed. Complications requiring surgical interventions were compared during a follow‐up period of 64 ± 31 months. Operation and fluoroscopic times were longer in DDD pacemaker implantation compared to VDD and VVI devices: 58 ± 23 versus 39 ± 10 and 37 ± 13 minutes (P < 0.001), 9.2 ± 5.2 versus 4.1 ± 2.4 and 3.5 ± 2.3 minutes , respectively. Differences remained significant after correction for covariates. In a multivariate Cox regression model, the corrected complication hazard of a DDD pacemaker implantation was increased by 3.9 (1.4–11.3) compared to VVI and increased by 2.3 (1.1–4.5) compared to VDD pacing. Higher complication rates in DDD pacing were mainly due to a higher incidence of early reoperation for atrial lead dysfunction, whereas the long‐term complication rate was not different from VDD or VVI pacing. Early and long‐term complication rates did not differ between VDD and VVI pacemaker systems. In conclusion, operation time and complication rates of physiological pacing are reduced by VDD pacemaker implantation achieving values comparable to VVI pacing. Thus, single lead VDD pacing can be recommended for patients with AV block. (PACE 2003; 26:1961–1969)
Bibliography:	ark:/67375/WNG-GCSSKJ7C-0 ArticleID:PACE303 istex:FAF10AF73024A07C0C052EA0230B9D507429D36A Received October 11, 2002; revised January 7, 2002; accepted January 22, 2003. ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0147-8389 1540-8159
DOI:	10.1046/j.1460-9592.2003.00303.x