Abstract
IntroductionThe pacemaker implantation VDD is considered simpler, faster, less expensive and causes fewer complications compared to DDD. However, the VDD pacemaker has not been widely used in many centers, perhaps for fear of dysfunction of the sinus node and the reduction of atrial sensitivity by the pacemaker during follow-up after implantation.ObjectiveTo compare patients with DDD and VDD pacemakers regarding the evolution of chronic atrial fibrillation (AF) and length of stay outside this postoperative arrhythmia.MethodsIt was included 158 patients with dual chamber pacemakers, 48 DDD and 110 VDD. Follow-up period: between January 1, 1999 and December 31, 2015. The mean follow-up of patients with DDD was 5.35 years and the VDD, 4.74 years. The percentage of each group (DDD and VDD) which evolved to AF during follow-up was assessed. Also, it was made an actuarial study with the respective curves indicating the time free from AF for each group. Patients were classified according to the diagnosis that led to pacemaker implantation and the degree of heart failure.ResultsThe percentage of patients who developed AF was higher in DDD group (10.42%) than in VDD group (6.36%), but without statistical significance. Patients with DDD and VDD remained free of AF for similar period.ConclusionConsidering the results, the VDD pacemaker continues to be a good option to the DDD for routine use in cases properly indicated.
Highlights
The pacemaker implantation VDD is considered simpler, faster, less expensive and causes fewer complications compared to DDD
Considering the results, the VDD pacemaker continues to be a good option to the DDD for routine use in cases properly indicated
The actuarial study comparing the incidence of atrial fibrillation (AF) in patients with dual chamber pacemaker DDD and VDD is shown in Figures 1, 2 and 3 and Tables 3 and 4
Summary
The pacemaker implantation VDD is considered simpler, faster, less expensive and causes fewer complications compared to DDD. The dual chamber pacemaker is widely used, especially in DDD mode, indicated in cases of atrioventricular heart block, among others. This type of stimulation offers many clinical advantages as it can maintain synchronization between atriums and ventricles leading to hemodynamic gain during the cardiac cycle and improves cardiac output. This type of cardiac stimulation can be used when the sinus node is normally functioning[1] In this case, only one lead is implanted, where its end remains in the right ventricle’s internal wall for stimulate and sense at this location. This same lead has a proximal pole that is positioned within the right atrium and at this point is only able to sense the heartbeats
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