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Quality of Life in Patients with Complete Heart Block and Paroxysmal Atrial Tachyarrhythmias: A Comparison of Permanent DDIR versus DDDR Pacing with Mode Switch to DDIR
Author(s) -
PROVENIER FRANK,
BOUDREZ HEDWIG,
DEHARO JEAN CLAUDE,
DJIANE PIERRE,
JORDAENS LUC
Publication year - 1999
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.1540-8159.1999.tb00474.x
Subject(s) - medicine , crossover study , quality of life (healthcare) , anesthesia , placebo , alternative medicine , nursing , pathology
A prospective double‐blind randomized crossover study was done in 15 patients with complete heart block and intermittent ATs. The pacemaker was randomly programmed to dual chamber inhibited rate responsive pacing (DDIR) and to DDDR with mode switch, for 1 month each. An event recorder was given to the patients and after each period, a QOL questionnaire was obtained. Based on telemetric data, all but two patients had AT during follow‐up. The duration and frequency of these episodes were not related to mode settings. AV synchrony was better preserved in DDDR (P < 0.05). Most symptom‐related event recordings during DDIR showed loss of AV synchrony; DDDR with mode switch caused symptoms due to tracking of ST. Overall the QOL score was not different between the modes. Fewer somatic complaints were noted during DDDR pacing than during baseline. DDIR stimulation showed no difference. Twelve patients preferred the period of DDDR pacing; one experienced severe symptoms during DDIR. In conclusion, patients with paroxysmal A, DDDR with mode switch, and DDIR had no influence on the occurrence, nor on the duration of AT episodes. AV synchrony was better preserved in DDDR, which was also associated with fewer somatic complaints compared to the baseline. In DDDR, symptoms were observed when ST was tracked. QOL was comparable, although more patients preferred DDDR.