Clinical comparison between single and dual chamber pacemakers in patients with advanced atrioventricular block

الملخص EN

Background : Several trials have compared (single chamber) ventricular pacing with dual chamber pacing.

Dual chamber pacing is believed to have an advantage over ventricular pacing.

Objective : The aim of the study was to determine whether patients with implanted pacemaker (PM) for complete atrioventricular block (AVB) gain significant benefit from dual chamber compared with single chamber ventricular demand.

Design : The study was cross sectional parallel, all results were expressed as means (SD) ; a P value less than 0.05 were regarded as significant.

Pair T- test was used to study all the variations.

All data were processed with SPSS 18.

Setting : Al-nasyria heart center, Dhyqar.

Patients ; sixty patients with high grade AVB who already underwent permanent pacemakers implant (single or dual chamber) were attending heart center for following up their devices.

Methods : the patients completed a (within-patient) comparison of symptoms, clinical finding, programming data, and echocardiographic finding during long term dual (VDD, DDD) pacing and long term ventricular demand (VVI) pacing.

Results : the study involved sixty patients, 23 (38.3 %) were males and 37 (61.7 %) were females.

Thirty three (55 %) patients had dual and twenty seven (45 %) patients had single chamber PM.

36 (60 %) patients were hypertensive while 23.3 (14 %) patients were diabetic and the number of the smokers was only 7 (11.7 %).

Majority of the patients from both groups lied within the age group (40-80y).

The most common indication was complete heart block.

The incidence of symptoms, systolic (but not diastolic) BP, and echocardiographic characteristics in both groups were parallel.

Conclusion : In patients with advanced AVB, there was no superiority of dual over single chamber PM concerning symptoms, systolic (but not diastolic) BP, programming data, and echocardiographic characteristics.