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Atrioventricular Sequential Pacemakers: Indications, Complications, and Long-Term Follow-up

1980; Elsevier BV; Volume: 29; Issue: 1 Linguagem: Inglês

10.1016/s0003-4975(10)61638-4

1552-6259

James J. Yashar, David L. Kitzes, Mohammad Arif, Richard A. Carleton, Mauricio Goldberg, Ralph J. Burnard, Albert K. Weyman, John Yashar,

Cardiac Valve Diseases and Treatments

Our experience with 32 patients with atrioventricular (AV) sequential pacemakers and an average follow-up of 22 months is presented.The pertinent literature and physiology are reviewed.The indications, advantages, and complications of AV sequential pacemakers are analyzed.Half of the patients required bifocal pacing for control of arrhythmia alone, while half required control of arrhythmia associated with congestive heart failure due primarily to a noncompliant left ventricle.It is anticipated that the hemodynamic improvement occurring as a result of AV sequential pacing will increase the use of this mode of cardiac pacing in selected patients.In the ten years since the introduction of atrioventricular (AV) sequential pacing, this, pacing modality has attracted little attention from clinicians [35].The lack of enthusiasm for permanent AV sequential pacing may be related to technical problems.The J lead for atrial pacing has proved difficult to position and has a higher tendency to dislodge compared with standard pervenous ventricular leads 1141.In addition, the size and configuration of early pulse generators limited its application due to surgical problems such as skin erosion.Despite these problems, more than 1,000 permanent AV sequential pacemakers have been implanted since 1969.*The early experience emphasized the hemodynamic benefits of AV sequential pacing [2, 6, 7, 10, 11, 171.This pacing modality was directed particularly toward those patients who had heart block and