Optimal side of implant for single-lead VDD pacing: Right-sided versus left-sided implantation

Haghjoo, M. and Arya, A. and Emkanjoo, Z. and Sadr-Ameli, M.A. (2005) Optimal side of implant for single-lead VDD pacing: Right-sided versus left-sided implantation. PACE - Pacing and Clinical Electrophysiology, 28 (5). pp. 384-390.

Pacing and Clinical Electrophysiology Volume 28 issue 5 2005 [doi 10.1111_j.1540-8159.2005.09459.x] MAJID HAGHJOO; ARASH ARYA; ZAHRA EMKANJOO; MOHAMMAD ALI SADR-AME -- Optimal Side of Implant for Si (1).pdf

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Background: Atrial undersensing occurs in a considerable number of patients with single-lead VDD pacing. This study tried to determine the role of implant side in maintenance of the VDD mode in patients with isolated atrioventricular (AV) block. Methods: Eighty-two patients with isolated AV block (46 females; mean age, 58 ± 17 years) received a single-lead VDD pacemaker (Medtronic Kappa, n = 70 and St. Jude Medical Affinity, n = 12). The patients were randomly assigned to one of two implantation groups (group I: right-sided VDD and group II: left-sided VDD). In each group, the P-wave amplitudes were determined at implantation, predischarge, 2-month, and 6-month follow-up. At each follow-up visit, stored event histograms of pacemaker were also retrieved. The atrial sensing measurements were compared between two groups. Results: Implantation was easier from right side (1.7 ± 1.0 vs 2.8 ± 1.7 attempts, P = 0.001). Implant P-wave was higher in group I compared to group II (4.2 ± 1.7 vs 2.7 ± 1.0 mV, P < 0.0001). During follow-up, higher P-wave amplitudes were obtained in group I both at predischarge (2.6 ± 1.3 vs 1.4 ± 1.1 mV, P < 0.0001), 2-month (2.8 ± 1.8 vs 1.3 ± 1.0 mV, P < 0.0001), and 6-month (2.9 ± 1.7 vs 1.3 ± 0.9 mV, P < 0.0001) evaluations but remained stable throughout the 6 months in both groups. After implantation, VDD function was better maintained in group I than group II (100 vs 90, P = 0.026). Incidence of atrial undersensing was lower in group I than group II (P = 0.026) in last follow-up visit. Conclusions: Implant side has a significant influence on atrial sensing performance in single-lead VDD pacing. Thus, right-side implantation should be the preferred approach for the implantation of VDD single-lead systems.

Item Type: Article
Additional Information: cited By 4
Uncontrolled Keywords: adolescent; adult; aged; article; artificial heart pacemaker; atrioventricular block; clinical trial; controlled clinical trial; controlled study; evaluation; female; follow up; heart pacing; histogram; human; incidence; major clinical study; male; P wave; randomized controlled trial; school child, Adolescent; Adult; Aged; Aged, 80 and over; Cardiac Pacing, Artificial; Child; Female; Follow-Up Studies; Heart Block; Humans; Male; Middle Aged; Treatment Outcome
Subjects: WU Dentistry. Oral Surgery
Depositing User: Librarian Farzaneh Dini
Date Deposited: 12 May 2019 09:35
Last Modified: 12 May 2019 09:35
URI: http://eprints.iums.ac.ir/id/eprint/12159

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