SSS Patients: Atrial or Dual-Chamber Pacing?
Symptomatic patients with sick sinus syndrome (SSS) are candidates for permanent pacemaker implantation. Single-chamber atrial (AAI) or dual-chamber (DDD) pacing rather than single-chamber ventricular (VVI) pacing is the recommended pacing mode, with rate response (-R) if appropriate . Most retrospective studies have demonstrated that mortality is greater in VVI paced patients and that atrial-based pacing is hemodynamically superior and associated with a lower rate of atrial fibrillation (AF) and thromboembolic complications [2–6]. Other observational studies comparing physiological (AAI or DDD) with VVI pacing, while they confirmed that VVI pacing was an independent predictor of AF and stroke, did not identify any difference in mortality and heart failure incidence between the two groups [7–9].
KeywordsVentricular Pace Atrial Pace Sick Sinus Syndrome Sinus Node Dysfunction Pace Modality
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- 5.Stangl K, Seitz K, Wirtzfeld A et al (1990) Differences between atrial single chamber pacing (AAI) and ventricular single chamber pacing (VVI) with respect to prognosis and antiarrhythmic effect in patients with sick sinus syndrome. Pacing Clin Electrophysiol 13:2080–2085PubMedCrossRefGoogle Scholar
- 7.Sgarbossa EB, Pinski SL, Maloney JD et al (1993) Chronic atrial fibrillation and stroke in paced patients with sick sinus syndrome. Relevance of clinical characteristics and pacing modalities. Circulation 88:1045–1053Google Scholar
- 16.AIAC Associazione Italiana di Aritmologia e Cardiostimolazione (1997) Registro Italiano Pacemaker e Defibrillatori. Associazione Italiana di Aritmologia e Cardiostimolazione, Roma, Bollettino periodico: registrazioni pacemaker gennaiodicembreGoogle Scholar