True incidence of pacemaker syndrome
| Autor: | John C. Messenger, Debra Heldman, Daniel Mulvihill, Arlene Rylaarsdam, Mark J. Castellanet, Karla Evans, Harold Nguyen |
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| Rok vydání: | 1990 |
| Předmět: |
Male
medicine.medical_specialty Pacemaker Artificial Hemodynamics Anxiety Pacemaker syndrome Dizziness law.invention Electrocardiography Randomized controlled trial law Internal medicine medicine Humans cardiovascular diseases Fatigue Aged Sinoatrial Node Aged 80 and over medicine.diagnostic_test business.industry Incidence (epidemiology) Incidence Cardiac Pacing Artificial Arrhythmias Cardiac General Medicine Syndrome Middle Aged medicine.disease Surgery Clinical trial medicine.anatomical_structure Blood pressure Dyspnea Heart Block Echocardiography Cardiology Atrioventricular Node Abdomen Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | Pacing and clinical electrophysiology : PACE. 13(12 Pt 2) |
| ISSN: | 0147-8389 |
| Popis: | Although the purported incidence of pacemaker syndrome according to the literature is only 5%-15%, this is based on a series of patients with VVI pacing. Increasing numbers of studies are being reported in which patients prefer the dual chamber mode despite little benefit being demonstrated on objective testing, suggesting that pacemaker syndrome may be more common than is generally reported. This study was designed to evaluate the reported symptoms in a series of patients programmed to both the VVI and one or more dual chamber modes. Forty unselected patients with dual chamber pacemakers were entered into a blind, randomized trial comparing the symptoms associated with VVI pacing to those associated with dual chamber pacing. Patients were randomized to either VVI or dual chamber pacing. At the end of 1 week, questionnaires rating 16 different symptoms were completed. Blood pressure, LV function, presence of ventriculoatrial conduction, and ability to override the pacemaker were evaluated. The pacemaker was then programmed to the other mode. Overall, 12 of 16 symptoms were significantly worse in the VVI as compared to dual chamber mode. The most highly significant (P less than 0.005) were shortness of breath, dizziness, fatigue, pulsations in the neck or abdomen, cough, and apprehension. Pacemaker syndrome was clinically recognized in 83% of patients paced in the VVI mode with 65% of patients experiencing moderate to severe symptoms. There were no readily identified clinical, hemodynamic, or electrophysiological parameters that predicted which patients would develop pacemaker syndrome. Thus, when patients have an opportunity to experience both pacing modes in close proximity to one another, there is a high incidence of pacemaker syndrome in the VVI mode. |
| Databáze: | OpenAIRE |
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