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Atrioventricular and Ventriculo‐Atrial Conduction in Patients with Symptomatic Sinus Node Dysfunction
Author(s) -
MECHELEN ROB,
HAGEMEIJER FRANS,
BOER HANS,
SCHELLING ADRI
Publication year - 1983
Publication title -
pacing and clinical electrophysiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.686
H-Index - 101
eISSN - 1540-8159
pISSN - 0147-8389
DOI - 10.1111/j.1540-8159.1983.tb06575.x
Subject(s) - medicine , cardiology , sinus (botany) , sick sinus syndrome , bradycardia , sinus bradycardia , cardiac pacing , atrioventricular node , atrioventricular block , heart block , ventricular pacing , anesthesia , electrocardiography , heart rate , heart failure , tachycardia , blood pressure , botany , biology , genus
In 14 patients with symptomatic sinus node dysfunction—sinus bradycardia, sino‐atrial exit block, or sinus arrest—electrophysiological studies were performed before implantation of a pacemaker. In 8 patients incremented high right atrial pacing showed AV‐nodal Wenckebach at pacing rates equal to or above 130/min (group I); in 6 patients AV‐nodal Wenckebach was reached at pacing rates Jess than 130/min (group II). During ventricular pacing at a rate 10–15% faster than the existing sinus rate, ventriculo‐atrial (VA) conduction was present in all patients of group I, while VA conduction was present in only 2 patients of group II (p < 0.05). Patients with symptomatic sinus node dysfunction but with intact AV conduction frequency show VA conduction during ventricular pacing and thus are particularly at risk for developing a pacemaker syndrome when a ventricular demand (VVI) pacemaker is implanted. This complication can be avoided by atrial demand (AAI) pacing or A V sequential (DVI) pacing. When adequate experience has been gathered with A V universel (DDD) pacemakers, the indications for selection of a pacemaker in patients with symptomatic sinus node dysfunction will probably change.