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Atrial rate-responsive pacing in sinus node disease.

M Rosenqvist·C Arén·B E Kristensson·R Nordlander·H Schüller
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Abstract

Patients with sinus node disease (SND) who are unable to achieve an adequate increase in heart rate during exercise are candidates for atrial rate-responsive pacing (AAI-R). We have implanted 40 AAI-R systems in SND patients with an average follow-up of 12.5 +/- 8 (range 3-30) months. All the patients received an activity-sensing pulse generator (Activitrax, Medtronic or Sensolog, Siemens-Pacesetter) with a single atrial lead. Only patients with an intraoperative AV nodal block cycle-length above 100 beats min-1 were included. During follow-up, one patient was observed to have transient asymptomatic 2:1 AV-block during sleep. No patient developed persistent AV-block or chronic atrial fibrillation. Twelve patients with persistent chronotropic incompetence were assigned for a randomized double-blind crossover study, comparing exercise treadmill capacity in AAI-R with conventional atrial inhibited pacing (AAI). During AAI-R pacing the maximum heart rate during exercise was 120 +/- 1 beats min-1 compared with 97 +/- 21 beats min-1 during AAI pacing (P less than 0.01). The average exercise time increased from 11.2 +/- 2 min during AAI-pacing to 13.4 +/- 3 min during AAI-R pacing (P less than 0.01). AAI pacing should be considered for patients with SND and chronotropic incompetence.

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Cardiac Pacing, ArtificialElectrocardiography, AmbulatoryExercise TestFollow-Up StudiesHeart BlockHeart RateHumansSinoatrial BlockJournal Article

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BibTeXRIS

M Rosenqvist, C Arén, B E Kristensson, R Nordlander, H Schüller. 1990. Atrial rate-responsive pacing in sinus node disease.. https://doi.org/10.1093/oxfordjournals.eurheartj.a059747

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