Pacemaker programming in patients with first-degree AV-block: Programming pattern and possible consequences

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Pacemaker programming in patients with first-degree AV-block : Programming pattern and possible consequences. / Holmqvist, F.; Rathakrishnan, B.; Jackson, L. R.; Campbell, K.; Daubert, J. P.

In: Health Science Reports, Vol. 1, No. 6, e39, 06.2018.

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Holmqvist, F. ; Rathakrishnan, B. ; Jackson, L. R. ; Campbell, K. ; Daubert, J. P. / Pacemaker programming in patients with first-degree AV-block : Programming pattern and possible consequences. In: Health Science Reports. 2018 ; Vol. 1, No. 6.

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TY - JOUR

T1 - Pacemaker programming in patients with first-degree AV-block

T2 - Programming pattern and possible consequences

AU - Holmqvist, F.

AU - Rathakrishnan, B.

AU - Jackson, L. R.

AU - Campbell, K.

AU - Daubert, J. P.

PY - 2018/6

Y1 - 2018/6

N2 - Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)–block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization. Methods: The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation and postimplantation electrocardiograms were analyzed. Results: A total of 74 patients were included (mean age, 75 ± 11 y; 53% men). The mean ± SD preimplant PR interval and QRS duration was 243 ± 46 and 110 ± 30 milliseconds, respectively. A history of atrial fibrillation was present in 49% of the patients, and 77% had a normal left ventricular ejection fraction. The majority of patients (65%) had their pacemakers programmed to atrial pacing (AAI/DDD +/−R), whereas 32% and 2.7% of the pacemakers were programmed to AV-sequential pacing (DDD) and ventricular pacing (VVI), respectively. There were no significant differences in baseline characteristics or electrocardiogram measures between patients programmed to the 3 pacing modes. Patients with pacemakers programmed to AAI had a lower ventricular pacing percentage at follow-up (8 vs 55, and 46% [DDD and VVI, respectively]; P <.001). Conclusions: There was no evident association between baseline characteristics and programmed pacing mode in patients with first-degree AV-block. The choice of pacing mode affects long-term pacing burden, which in turn has been shown to influence outcome.

AB - Background: The optimal way of pacing in patients with an indication for pacing and concomitant first-degree atrioventricular (AV)–block is not known, and consequently, firm guidelines on this topic are lacking. This study explored the current pacemaker programming pattern in patients with first-degree AV-block who have a dual chamber pacemaker without cardiac resynchronization. Methods: The study was a retrospective chart review conducted at Duke University Hospital. Patients receiving a pacemaker due to sinus node dysfunction with coexistent first-degree AV-block were studied. Baseline demographics and characteristics, as well as pacemaker programming parameters and follow-up data, were collected through chart review. Preimplantation and postimplantation electrocardiograms were analyzed. Results: A total of 74 patients were included (mean age, 75 ± 11 y; 53% men). The mean ± SD preimplant PR interval and QRS duration was 243 ± 46 and 110 ± 30 milliseconds, respectively. A history of atrial fibrillation was present in 49% of the patients, and 77% had a normal left ventricular ejection fraction. The majority of patients (65%) had their pacemakers programmed to atrial pacing (AAI/DDD +/−R), whereas 32% and 2.7% of the pacemakers were programmed to AV-sequential pacing (DDD) and ventricular pacing (VVI), respectively. There were no significant differences in baseline characteristics or electrocardiogram measures between patients programmed to the 3 pacing modes. Patients with pacemakers programmed to AAI had a lower ventricular pacing percentage at follow-up (8 vs 55, and 46% [DDD and VVI, respectively]; P <.001). Conclusions: There was no evident association between baseline characteristics and programmed pacing mode in patients with first-degree AV-block. The choice of pacing mode affects long-term pacing burden, which in turn has been shown to influence outcome.

KW - first-degree AV-block

KW - pacemaker programming

KW - sinus node dysfunction

UR - http://www.scopus.com/inward/record.url?scp=85083483956&partnerID=8YFLogxK

U2 - 10.1002/hsr2.39

DO - 10.1002/hsr2.39

M3 - Article

VL - 1

JO - Health Science Reports

JF - Health Science Reports

SN - 2398-8835

IS - 6

M1 - e39

ER -