Journal Article

Single-chamber ventricular pacing increases markers of left ventricular dysfunction compared with dual-chamber pacing

Barbara Naegeli, David J. Kurz, David Koller, Edwin Straumann, Marcel Furrer, Dominik Maurer, Elisabeth Minder and Osmund Bertel

in EP Europace

Published on behalf of European Heart Rhythm Association of the European Society of Cardiology (ESC)

Volume 9, issue 3, pages 194-199
Published in print March 2007 | ISSN: 1099-5129
Published online February 2007 | e-ISSN: 1532-2092 | DOI: http://dx.doi.org/10.1093/europace/eul186
Single-chamber ventricular pacing increases markers of left ventricular dysfunction compared with dual-chamber pacing

Show Summary Details

Preview

Aims Large randomized trials comparing DDD with VVI pacing have shown no differences in mortality, but conflicting evidence exists in regard to heart failure endpoints. Here we evaluated the effect of pacing mode on serum levels of brain natriuretic peptide (BNP) and amino-terminal-proBNP (NT-proBNP).

Methods Forty-one patients (age 73 ± 10 years) with dual-chamber pacemakers were included in a prospective, single-blind, randomized crossover study evaluating the impact of DDD(R)/VDD versus VVI(R) mode on objective and functional parameters. Data were collected after a 2-week run-in phase and after 2 weeks each of VVI(R) and DDD(R)/VDD pacing or vice versa.

Results BNP and NT-proBNP levels during DDD(R)/VDD stimulation (151 ± 131 and 547 ± 598 pg/mL) showed no change compared with baseline (154 ± 130 and 565 ± 555 pg/mL), but a significant 2.4-fold increase was observed during VVI(R) mode [360 ± 221 and 1298 ± 1032 pg/mL; P < 0.001 compared with DDD(R)/VDD]. The assessment of functional class, the presence of pacemaker syndrome [49% in VVI(R) mode] and the patients' preferred pacing mode showed significant differences in favour of DDD(R)/VDD pacing.

Conclusion Patients can differentiate between DDD(R)/VDD and VVI(R) pacing, and prefer the former. Compared with DDD(R)/VDD pacing, VVI(R) stimulation induces a two- to three-fold increase in serum BNP and NT-proBNP levels.

Keywords: Pacing; Natriuretic peptides; Pacemaker syndrome; Echocardiography

Journal Article.  4024 words.  Illustrated.

Subjects: Cardiovascular Medicine

Full text: subscription required

How to subscribe Recommend to my Librarian

Users without a subscription are not able to see the full content. Please, subscribe or login to access all content.