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Long-term outcome of single-chamber atrial pacing compared with dual-chamber pacing in patients with sinus-node dysfunction and intact atrioventricular node conduction

 Won Ho Kim  ;  Boyoung Joung  ;  Jaemin Shim  ;  Jong Sung Park  ;  Eui-Seock Hwang  ;  Hui-Nam Pak  ;  Sungsoon Kim  ;  Moonhyoung Lee 
 YONSEI MEDICAL JOURNAL, Vol.51(6) : 832-837, 2010 
Journal Title
Issue Date
Aged ; Atrial Fibrillation/complications ; Atrial Fibrillation/physiopathology ; Atrioventricular Node/physiopathology* ; Cardiac Pacing, Artificial ; Cohort Studies ; Female ; Follow-Up Studies ; Heart Failure/complications ; Humans ; Male ; Middle Aged ; Proportional Hazards Models ; Retrospective Studies ; Sick Sinus Syndrome/physiopathology* ; Treatment Outcome
Sinus node dysfunction ; intact AV conduction
PURPOSE: The optimal pacing mode with either single chamber atrial pacemaker (AAI or AAIR) or dual chamber pacemaker (DDD or DDDR) is still not clear in sinus-node dysfunction (SND) and intact atrioventricular (AV) conduction. MATERIALS AND METHODS: Patients who were implanted with permanent pacemaker using AAI(R) (n = 73) or DDD(R) (n = 113) were compared. RESULTS: The baseline characteristics were comparable between the two groups, with a mean follow-up duration of 69 months. The incidence of death did not show statistical difference. However, the incidence of hospitalization for congestive heart failure (CHF) was significantly lower in the AAI(R) group (0%) than the DDD(R) group (8.8%, p = 0.03). Also, atrial fibrillation (AF) was found in 2.8% in the AAI(R) group, which was statistically different from 15.2% of patients in the DDD(R) group (p = 0.01). Four patients (5.5%) with AAI(R) developed AV block, and subsequently switched to DDD(R) pacing. The risk of AF was lower in the patients implanted with AAI(R) than those with DDD(R) [hazard ratio (HR), 0.84; 95% confidence interval, 0.72 to 0.97, p = 0.02]. CONCLUSION: In patients with SND and intact AV conduction, AAI(R) pacing can achieve a better clinical outcome in terms of occurrence of CHF and AF than DDD(R) pacing. These findings support AAI(R) pacing as the preferred pacing mode in patients with SND and intact AV conduction
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Sung Soon(김성순)
Park, Jong Seoung(박종성)
Pak, Hui Nam(박희남) ORCID logo https://orcid.org/0000-0002-3256-3620
Shim, Jae Min(심재민)
Lee, Moon Hyoung(이문형) ORCID logo https://orcid.org/0000-0002-7268-0741
Joung, Bo Young(정보영) ORCID logo https://orcid.org/0000-0001-9036-7225
Hwang, Eui Seock(황의석)
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