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  • Title: [The atrial pacemaker as therapy in sinus node disease: retrospective analysis of complications and rate of survival].
    Author: Lemke B, Hoeltmann BJ, Selbach H, Barmeyer J.
    Journal: Z Kardiol; 1987 Aug; 76(8):484-91. PubMed ID: 3673168.
    Abstract:
    The implantation of an atrial pacing device represents an established mode of therapy for bradycardia in sinus node dysfunction. However, controversial views remain concerning the safety of this type of pacing. To investigate this, we retrospectively analysed data from 81 patients, all of whom received an AAI pacing device between 1972 and 1984. Complete AV-block developed in two out of 81 patients (cumulative incidence after 10 years was 5 +/- 3%). Atrial fibrillation developed in three out of 81 patients (cumulative incidence after 10 years was 10 +/- 5%). Lead-related complications were strongly related to the type of lead tip and the mode of fixation. The overall incidence of lead-related problems was 20 +/- 5% after 5 years and 38 +/- 12% after 10 years. 82 +/- 6% of patients survived the first 5 years, 52 +/- 14% survived for 10 years. The 5 years' survival rate was not different from that of the normal population. From this we conclude that atrial pacing can be safely done with an AAI system as long as there are no signs of an AV-block. Atrial fibrillation develops less often on AAI pacing than on VVI pacing. The risk of developing an AV-block seems rather low.
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