Please use this identifier to cite or link to this item: http://hdl.handle.net/2381/12611
Title: Heart failure in patients with sick sinus syndrome treated with single lead atrial or dual-chamber pacing: no association with pacing mode or right ventricular pacing site.
Authors: Riahi, S
Nielsen, JC
Hjortshøj, S
Thomsen, PE
Højberg, S
Møller, M
Dalsgaard, D
Nielsen, T
Asklund, M
Friis, EV
Christensen, PD
Simonsen, EH
Eriksen, UH
Jensen, GV
Svendsen, JH
Toff, WD
Healey, JS
Andersen, HR
on behalf of the DANPACE Investigators
First Published: Oct-2012
Citation: EUROPACE, 2012, 14 (10), pp. 1475-1482
Abstract: AIMS: Previous studies indicate that ventricular pacing may precipitate heart failure (HF). We investigated occurrence of HF during long-term follow-up among patients with sick sinus syndrome (SSS) randomized to AAIR or DDDR pacing. Furthermore, we investigated effects of percentage of ventricular pacing (%VP) and pacing site in the ventricle. METHODS AND RESULTS: We analysed data from 1415 patients randomized to AAIR (n = 707) or DDDR pacing (n = 708). Ventricular pacing leads were recorded as located in either an apical or a non-apical position. The %VP and HF hospitalizations were recorded during follow-up. Patients were classified with new HF, if in New York Heart Association (NYHA) functional class IV or if presence of ≥2 of: oedema; dyspnoea; NYHA functional class III. Mean follow-up was 5.4 ± 2.4 years. Heart failure hospitalizations did not differ between groups. In the AAIR group, 170 of the 707 (26%) patients developed HF vs. 169 of the 708 (26%) patients in the DDDR group, hazard rate ratio (HR) 1.00, 95% confidence interval (CI) 0.79-1.22, P = 0.87. In DDDR patients, 146 of the 512 patients (29%) with ventricular leads in an apical position developed HF vs. 28 of the 161 patients (17%) with the leads in a non-apical position, HR 0.67, CI 0.45-1.00, P = 0.05. After adjustments this difference was non-significant. The incidence of HF was not associated with %VP (P = 0.57). CONCLUSION: In patients with SSS, HF was not associated with pacing mode, %VP, or ventricular lead localization. This suggests that DDDR pacing is safe in patients with SSS without precipitating HF.
DOI Link: 10.1093/europace/eus069
eISSN: 1532-2092
Links: http://hdl.handle.net/2381/12611
Type: Journal Article
Appears in Collections:Published Articles, Dept. of Cardiovascular Sciences

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