Dual chamber vs single chamber pacing for AV block- Which to choose?
Written By : Dr. Nandita Mohan
Medically Reviewed By : Dr. Kamal Kant Kohli
Published On 2022-09-29 04:15 GMT | Update On 2022-09-29 04:15 GMT
Complete heart block occurs when the electrical signal can't pass normally from the atria, to the ventricles. If the atrioventricular (AV) node is damaged during surgery, complete heart block may result. Sometimes complete heart block occurs spontaneously without surgery.Patients with complete heart block are usually treated with either a single chamber or a dual chamber pacemaker. The lack of...
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Complete heart block occurs when the electrical signal can't pass normally from the atria, to the ventricles. If the atrioventricular (AV) node is damaged during surgery, complete heart block may result. Sometimes complete heart block occurs spontaneously without surgery.
Patients with complete heart block are usually treated with either a single chamber or a dual chamber pacemaker. The lack of a significant long term benefit with dual chamber pacemakers may be because the ventricular desynchrony with right ventricular pacing outweighs the benefits of atrioventricular synchrony. About 70–85% of the devices implanted are dual chamber in western countries.
The study that I am talking about was designed to evaluate the difference in functional capacity between the two modes in the short term in patients with atrioventricular block.
A total of 42 patients were studied for primary outcomes of quality of life and 6-minute walking distance between Dual sensor ventricular demand rate responsive and dual chamber pacing modes. At end of 2 months after device implantation, randomization was done and the device was programmed to Dual sensor ventricular demand rate responsive or dual chamber pacing modes.
Researchers found no difference in functional capacity and quality of life between the two pacing modes. None of the patients developed pacemaker syndrome and there was no preference for any of the modes.
In patients with complete heart block, there was no difference in quality of life and functional capacity in the short term when programmed to Dual sensor ventricular demand rate responsive or dual chamber pacing modes.
Reference:
Ragavendra Chanthanamuthu, Sakthivel Ramasamy, et al; Short term outcomes with dual chamber versus single chamber pacing for atrioventricular block - A crossover trial, Indian Heart Journal,Volume 74, Issue 4, 2022, DOI: https://doi.org/10.1016/j.ihj.2022.06.003.
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