New concepts in pacemaker syndrome

Michael D. Farmer, N. A.Mark Estes, Mark S. Link

Research output: Contribution to journalReview article

8 Citations (Scopus)

Abstract

After implantation of a permanent pacemaker, patients may experience severe symptoms of dyspnea, palpitations, malaise, and syncope resulting from pacemaker syndrome. Although pacemaker syndrome is most often ascribed to the loss of atrioventricular (A-V) synchrony, more recent data may also implicate left ventricular dysynchrony caused by right ventricular pacing. Previous studies have not shown reductions in mortality or stroke with rate-modulated dual-chamber (DDDR) pacing as compared to ventricular-based (VVI) pacing. The benefits in A-V sequential pacing with the DDDR mode are likely mitigated by the interventricular (V-V) dysynchrony imposed by the high percentage of ventricular pacing commonly seen in the DDDR mode. Programming DDDR pacemakers to encourage intrinsic A-V conduction and reduce right ventricular pacing will likely decrease heart failure and pacemaker syndrome. Studies are currently ongoing to address these questions.

Original languageEnglish (US)
Pages (from-to)195-200
Number of pages6
JournalIndian Pacing and Electrophysiology Journal
Volume4
Issue number4
StatePublished - Oct 1 2004

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Syncope
Dyspnea
Heart Failure
Stroke
Mortality

Keywords

  • A-V = atriovetricular
  • AAI = single-chamber atrial
  • AF = atrial fibrillation
  • DDDR = rate modulated dual-chamber
  • LBBB - left bundle branch block
  • LV = left ventricular
  • LVEF = left ventricular ejection fraction
  • RV = right ventricular
  • SND = sinus node dysfunction
  • V-A = ventricular-atrial
  • V-V = interventricular
  • VVI = ventricular-based
  • VVIR = rate modulated ventricular-based

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Physiology (medical)

Cite this

New concepts in pacemaker syndrome. / Farmer, Michael D.; Estes, N. A.Mark; Link, Mark S.

In: Indian Pacing and Electrophysiology Journal, Vol. 4, No. 4, 01.10.2004, p. 195-200.

Research output: Contribution to journalReview article

Farmer, MD, Estes, NAM & Link, MS 2004, 'New concepts in pacemaker syndrome', Indian Pacing and Electrophysiology Journal, vol. 4, no. 4, pp. 195-200.
Farmer, Michael D. ; Estes, N. A.Mark ; Link, Mark S. / New concepts in pacemaker syndrome. In: Indian Pacing and Electrophysiology Journal. 2004 ; Vol. 4, No. 4. pp. 195-200.
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N2 - After implantation of a permanent pacemaker, patients may experience severe symptoms of dyspnea, palpitations, malaise, and syncope resulting from pacemaker syndrome. Although pacemaker syndrome is most often ascribed to the loss of atrioventricular (A-V) synchrony, more recent data may also implicate left ventricular dysynchrony caused by right ventricular pacing. Previous studies have not shown reductions in mortality or stroke with rate-modulated dual-chamber (DDDR) pacing as compared to ventricular-based (VVI) pacing. The benefits in A-V sequential pacing with the DDDR mode are likely mitigated by the interventricular (V-V) dysynchrony imposed by the high percentage of ventricular pacing commonly seen in the DDDR mode. Programming DDDR pacemakers to encourage intrinsic A-V conduction and reduce right ventricular pacing will likely decrease heart failure and pacemaker syndrome. Studies are currently ongoing to address these questions.

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KW - V-A = ventricular-atrial

KW - V-V = interventricular

KW - VVI = ventricular-based

KW - VVIR = rate modulated ventricular-based

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