Quality of life in patients with complete heart block and paroxysmal atrial tachyarrhythmias: A comparison of permanent DDIR versus DDDR pacing with mode switch to DDIR

A prospective double-blind randomized crossover study was done in 15 patien ts with complete heart block and intermittent ATs. The pacemaker was random ly programmed to dual chamber inhibited rate responsive pacing (DDIR) and t o DDDR: with mode switch, for I month each. An event recorder was given to the patients and after each period, a QOL questionnaire was obtained. Based on telemetric data, all but two patients had AT during follow-up. The dura tion and frequency of these episodes were not related to mode settings. AV synchrony was better preserved in DDDR (P < 0.05). Most symptom-related eve nt recordings during DDIR showed lass of AV synchrony:. DDDR with mode swit ch caused symptoms due to tracking of ST. Overall the QOL score was not dif ferent between the modes. Fen er somatic complaints were noted during DDDR pacing than during baseline. DDIR stimulation showed no difference. Twelve patients preferred the period of DDDR pacing; one experienced severe sympto ms during DDIR. In conclusion, patients with paroxysmal AT, DDDR with mode switch, and DDIR had no influence on the occurrence, nor on the duration of AT episodes. Air synchrony was better preserved in DDDR, which was also as sociated with fewer somatic complaints compared to the baseline. In DDDR, s ymptoms iz ere observed when ST was tracked. QOL was comparable, although m ore patients preferred DDDR.