Does DDD pacing with minimized ventricular stimulation prevent atrial fibrillation in sinus-node disease?
Luigi Padeletti
Correspondence Institute of Internal Medicine and Cardiology, University of Florence, Viale Morgagni, 85, Florence 50134, Italy
Email lpadeletti@interfree.it
This article has no abstract so we have provided the first paragraph of the full text.
The prevalence of AF among SND patients with a cardiac pacemaker increases from 31% at implantation to 52% after 6 years.1 A substantial number of these patients remain asymptomatic, and, in controlled trials, only about 30% received anticoagulation therapy.2 AF is significantly more common among patients receiving single-chamber ventricular pacing than in those receiving physiologic AAI(R) [atrial inhibited, rate responsive] or DDD(R) [dual-chamber universal, rate responsive] pacing, both in individuals with SND and in those with atrioventricular block.3 AAI(R) and DDD(R) pacing modes preserve atrioventricular synchrony, but ventricular desynchronization due to RV apical pacing in the DDD(R) mode has been reported to increase the incidence of both AF4 and HFH5 in patients with SND. AAI(R) pacing preserves a normal ventricular activation sequence, but requires stable atrioventricular conduction.
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