Short and long terms results of dual chamber pacemaker use

Background: Continuous improvement of dual chamber DDD pacemakers, electrod e stability and programmed sequential stimulation changed the prognosis of patients implanted with these devices. Aim: To report our experience with t he use of dual chamber pacemakers. Material and methods: One hundred sevent y six patients (116 male), aged 13 to 91 years old, who received a dual cha mber pacemaker implant, are reported. Patients were followed for a mean of 2.6 years. Results: Indications for DDD pacemaker were complete atrioventri cular block in 43%, sick sinus syndrome in 32%, paroxysmal A-V block in 24% . All pacemakers were Siemens-Pacesetter and were provided with an automati c sensing and threshold device. J shaped atrium electrodes were used in 78% of patients and screw-in electrodes in 22%. Post operative complications w ere displacement of atrial electrode in 8 patients, of ventricular electrod e in 6 patients, infection in two patient and a hematoma in one. Chronic pa rameters, measured after six months, were within expected ranges and allowe d a good reprogramming of pacemakers. Long term programming aimed to reduce battery depletion, enhance device performance and improve hemodynamic cond itions. Normal sequential stimulation was achieved in 154 patients (87%), 1 4 (85) patients died of cardiovascular disease not related to pacemaker fun ction. Eight patients were in atrial fibrillation and were reprogrammed to VVI and DDI modes. Conclusions: DDD pacemakers are reliable and afford symp tomatic relief in a broad spectrum of patients.