Long-Term Follow-Up of Single-Lead VDD Pacing System
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概要
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<B>Introduction:</B> Single-lead VDD system is an alternative mode of cardiac pacing in patients with atrioventricular (AV) block and preserved sinus node function (SN). The aim of this study was to find the predictors of atrial undersensing in long-term VDD-pacing systems. <B>Methods:</B> Ninety-three patients (80.5±9.6-year-old) with normal SN who received single-lead VDD system and 61 patients (78±11-year-old) with normal SN who received dual-lead DDD system were enrolled. Before the pacemaker implantation, we evaluated 13 parameters (age, gender, type of AV block, hypertension, diabetes, heart failure, ischemic heart disease, atrial fibrillation, chronic renal failure, antiarrhythmic agents, digitalis, calcium channel blocker and atrial amplitude of P wave at implantation). We followed up the patients at our outpatient clinic. <B>Results:</B> In VDD group, Mean follow-up duration was 75±41 months (24–173). Atrial undersensing was detected in 17 patients. According to a Kaplan-Meier analysis, heart failure (P=0.0009), P wave <0.8 mV (P=0.0200), digitalis (P=0.0185), antiarrhythmic agents (P=0.0010) and age >82 years (P=0.0393) were significant predictor of atrial undersensing. A Cox regression analysis showed that the heart failure was an independent predictor (hazard ratio, 4.525; 95% confidence interval, 1.437–14.286, P=0.0032). Re-operation was required in 3 patients. <B>Conclusion:</B> These results indicate that VDD mode is not preferable in the AV block patient who has a history of heart failure even if the SN and atrial amplitude are preserved.
著者
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Yano Akio
cardiovascular medicine, Tottori university hospital
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Miake Junichiro
cardiovascular medicine, Tottori university hospital
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Kato Masaru
cardiovascular medicine, Tottori university hospital
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Iitsuka Kazuhiko
cardiovascular medicine, Tottori university hospital
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Yamamoto Kazuhiro
Cardiovascular Div. Of Osaka Police Hospital
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Inoue Yoshiaki
Cardiovascular Medicine Tottori University Hospital
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Adachi Masamitsu
Cardiovascular Medicine Tottori University Hospital
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Kondo Takehito
Cardiovascular Medicine Tottori University Hospital
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Adachi Masamitsu
Cardiovascular Medicine, Tottori University Faculty of Medicine
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Ogura Kazuyoshi
Cardiovascular Medicine, Tottori University Faculty of Medicine
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Yano Akio
Cardiovascular Medicine, Tottori University Faculty of Medicine
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Iitsuka Kazuhiko
Cardiovascular Medicine, Tottori University Faculty of Medicine
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Kondo Takehito
Cardiovascular Medicine, Tottori University Faculty of Medicine
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Miake Junichiro
Cardiovascular Medicine, Tottori University Faculty of Medicine
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Inoue Yoshiaki
Cardiovascular Medicine, Tottori University Faculty of Medicine
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