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- Title
Optimal Side of Implant for Single-Lead VDD Pacing: Right-Sided Versus Left-Sided Implantation.
- Authors
HAGHJOO, MAJID; ARYA, ARASH; EMKANJOO, ZAHRA; SADR‐AMELI, MOHAMMAD ALI
- Abstract
HAGHJOO, M.,et al.: Optimal Side of Implant for Single-Lead VDD Pacing: Right-Sided Versus Left-Sided Implantation. Background:Atrial undersensing occurs in a considerable number of patients with single-lead VDD pacing. This study tried to determine the role of implant side in maintenance of the VDD mode in patients with isolated atrioventricular (AV) block.Methods:Eighty-two patients with isolated AV block (46 females; mean age, 58± 17 years) received a single-lead VDD pacemaker (Medtronic Kappa, n= 70 and St. Jude Medical Affinity, n= 12). The patients were randomly assigned to one of two implantation groups (group I: right-sided VDD and group II: left-sided VDD). In each group, the P-wave amplitudes were determined at implantation, predischarge, 2-month, and 6-month follow-up. At each follow-up visit, stored event histograms of pacemaker were also retrieved. The atrial sensing measurements were compared between two groups.Results:Implantation was easier from right side (1.7± 1.0 vs 2.8± 1.7 attempts, P= 0.001). Implant P-wave was higher in group I compared to group II (4.2± 1.7 vs 2.7± 1.0 mV, P<0.0001). During follow-up, higher P-wave amplitudes were obtained in group I both at predischarge (2.6± 1.3 vs 1.4± 1.1 mV, P<0.0001), 2-month (2.8± 1.8 vs 1.3± 1.0 mV, P<0.0001), and 6-month (2.9± 1.7 vs 1.3± 0.9 mV, P<0.0001) evaluations but remained stable throughout the 6 months in both groups. After implantation, VDD function was better maintained in group I than group II (100% vs 90%, P= 0.026). Incidence of atrial undersensing was lower in group I than group II (P= 0.026) in last follow-up visit.Conclusions:Implant side has a significant influence on atrial sensing performance in single-lead VDD pacing. Thus, right-side implantation should be the preferred approach for the implantation of VDD single-lead systems.(PACE 2005; 28:384–390)
- Subjects
CARDIAC pacing; ELECTRIC stimulation; CARDIAC pacemakers; IMPLANTED cardiovascular instruments; LEAD
- Publication
Pacing & Clinical Electrophysiology, 2005, Vol 28, Issue 5, p384
- ISSN
0147-8389
- Publication type
Article
- DOI
10.1111/j.1540-8159.2005.09459.x