Clinical implications of elective replacement indicator setting changes in patients with dual-chamber pacemaker devices.

Journal of Cardiovascular Electrophysiology
Kari A PhillipsSamuel J Asirvatham

Abstract

This study sought to determine if single-chamber operation and/or loss of rate response (RR) during elective replacement indicator (ERI) in patients with dual-chamber pacemakers lead to increased symptom burden, healthcare utilization, and atrial fibrillation (AF). Dual-chamber pacemakers often change from dual- to single-chamber pacing mode and/or lose RR functionality at ERI to preserve battery. Single-chamber pacing increases the incidence of heart failure, AF, and pacemaker syndrome suggesting these changes may be deleterious. A retrospective analysis of 700 patients was completed. Three comparisons were analyzed: Comparison 1: mode change and RR loss versus no change; Comparison 2: RR loss only versus no change; Comparison 3: mode change only versus no change (in patients with no RR programmed at baseline). In Comparison 1, 121 (46%) patients with setting changes experienced symptoms (most often dyspnea and fatigue/exercise intolerance) versus 3 (4%) without setting changes (p < .0001). Similar results were noted in Comparisons 2 and 3 (p = .0016 and p = .0001, respectively). In Comparison 1, patients with setting change sought provider contact more than patients without setting changes (p = .0001). A significant differenc...Continue Reading

References

Jun 14, 2002·The New England Journal of Medicine·Gervasio A LamasUNKNOWN Mode Selection Trial in Sinus-Node Dysfunction
Oct 31, 2018·Pacing and Clinical Electrophysiology : PACE·Sunil K SinhaJoseph E Marine

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