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A Comparison of VVIR and DDDR Pacing Following Cardiac Transplantation
Author(s) -
ROELKE MARC,
McNAMARA DENNIS,
OSSWALD STEFAN,
SEMIGRAN MARC,
DEC WILLIAM,
HARTHORNE J. WARREN
Publication year - 1994
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.1540-8159.1994.tb03798.x
Subject(s) - medicine , transplantation , cardiac pacing , cardiology , intensive care medicine
We compared the clinical course of patients paced in VVIR versus DDDR mode to determine the most appropriate method of pacing following cardiac transplantation. Pacemaker implantation was required in 9 of 90 orthotopic cardiac transplants (10%). Indications included sinus bradycardia or sinus arrest (8 patients) and AV node dysfunction (1 patient). VVIR pacemakers were implanted in four patients and DDDR in five patients. DDDR patients : The mean P wave was 1.7 mV and the mean atrial stimulation threshold was 0.8 V (at 0.5 msec). During follow‐up of 20 months, two atrial lead complications developed (29% of leads in 33% of patients). No lead complications were directly related to endomyocardial biopsy. VVIR patients : All four patients developed VA conduction with mean VA time 180 msec (160–240 msec). Two patients developed pacemaker syndrome. Conclusions : VA conduction and pacemaker syndrome may develop in cardiac transplant recipients paced in the VVIR mode. Dual chamber pacing is technically feasible and preferable following cardiac transplantation.