Clinic Application Research Of Different Physiological Pacing Mode

Objectives To compare the heart function and quality of life for patients who implanted DDD pacemaker programming AAI(R) mode and DDDS(R) mode namely short AV delay, following sick sinus syndrome with normal atrio-ventricular conduction. Methods The study enrolls sixty DDD pacemaker patients consecutively from January 1999 to January 2004,male 34,female 26,age 16-83 years, mean 63.7±12.5 years, randomly divided into AAI(R)group and DDDS(R) group. Of the sixty patients, twenty five patients in sinus bradycardia, sinus-atrial conduction block in eighteen , sinus arrest in six , brady-tachycardia in eleven, observing the heart function, changes of echocardiography, scores of Quality of life (QOL) from baseline, six month and twelve month, respectively. Results At the end of the follow-up,in AAI group,three patients developed to permanent atrial fibrillation (Afi),one died of primary hepatic carcinoma, two hospitalized following congestive heart failure (CHF).In DDD group, five patients developed to permanent Afi, one case of cerebral infarction, three hospitalizied following CHF. Echocardiography changes : compared with DDD group, no significant changes were observed in AAI group ,P > 0.05,in LA,LVEDD,LVESD,LVFS and LVEF, respectively. The same result was also found in NYHA heart function class. QOL scores: compared with AAI group, Hacettepe questionnaire score decreased significantly from baseline 117.0 + 16.7 to 12 month 112.3 + 9.5, P < 0.05.Karolinska questionnaire score of cardiovascular symptoms in AAI group decreased from 18.3 + 12.6 to 9.2 + 5.4, DDD group from 19.7+11.0 to30.4 + 14.5, P < 0.05. The items of palpitation, dizzness, shortness of breath were also seen elevation in DDD group. Conclusions Compared with DDD pacing mode,AAI pacing mode is more physiological than DDD pacing mode, with less CHF events, less prevalence of Afi, acceptable heart function and improved QOL, meanwhile with simplified implanted method, stable eletro-code and high cost-efficacy. So for patients in sick sinus syndrome with normal atrio-ventricular conduction, AAI pacing mode should be accepted and applied by more clinicians.