Dijkshoorn, L.A. (Leonard) (2021) Long-term assessment of atrial and ventricular pacing percentages in dual-chamber pacemakers reveals substantial differences between pacing indications. thesis, Medicine.
Full text available on request.Abstract
Background: Transvenous pacemakers are associated with a considerable number of lead- and pocket-related complications. The innovation of a dual-chamber leadless pacemaker (LP) is a promising alternative. The pacing percentage seriously impacts battery consumption and is vital for an adequate risk stratification for dual-chamber LPs. This study quantifies the pacing percentage per indication Methods: In this retrospective single-center cohort study, consecutive patients with a primary transvenous pacemaker implantation between January 2000 and January 2020 were included. Patients were categorized in the following indication-groups: sinus node dysfunction (SND), incomplete (IAVB) or complete atrioventricular block (CAVB). Primary outcomes were atrial and ventricular pacing percentages, secondary outcomes were electrical atrial parameters. Results: In our cohort (n=793) with an average age of 71.1 years and median follow-up of 2.9 years, we observed three equal indication groups. Median atrial pacing was 10.8% (IQR: 2.0-34.3%) for IAVB, 10.0% (IQR: 1.0-30.6%) for CAVB and 38.0% (IQR: 12.1-72.4%) for SND. Median ventricular pacing percentage was 78.6% (IQR 28.9-98.3%) for IAVB, 98.2% (IQR: 67.3- 99.8%) for CAVB, and 7.5% (IQR: 1.0-35.7%) for SND. During follow-up a median atrial impedance of 475 Ohm (IQR: 419-532), a median atrial threshold of 0.72V (IQR: 0.58-0.90) and a median P-wave amplitude of 2.50mV (IQR: 1.89-2.60) was observed. Conclusions: Significant differences in yearly and overall atrial and ventricular pacing percentages are observed for different pacing indications. As the exact energy use of the novel wireless communication technique in dual-chamber LPs is unknown and the ventricular component is most vital, this new LP might be implanted first in SND patients.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Breeman, drs. K.T.N. and Oosterwerff, drs. F.J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 06 Jan 2022 09:10 |
| Last Modified: | 06 Jan 2022 09:10 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/2961 |
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