The contribution of rate adaptive pacing with single or dual sensors to health-related quality of life.

Aims: The characteristics of sensors to perform rate adaptive pacing are well established but whether their contribution improves health-related quality of life (QoL) remains disputable. To compare the effects on QoL with an integrated dual sensor [minute ventilation (MV) and acceleration, TT sensor] with a single MV sensor, and with no rate adaptive pacing.

Methods And Results: This Dutch multi centre, prospective, single- (patient) blind study was performed in patients after first pacemaker (PM) implant for sick sinus syndrome or AV block.

Health-related quality of life relative to clinical outcomes in patients with atrial fibrillation treated with ventricular rate stabilisation pacing.

Aims: It is uncertain whether patient perception of atrial fibrillation (AF) is based on the fast ventricular rate as such or the irregularity of the ventricular responses. This trial was designed to confirm the effectiveness of a ventricular rate stabilisation (VRS) algorithm in reducing ventricular irregularity during permanent pacing in patients with AF and to assess the patient preference and effect on quality of life (QoL).

Methods: In this multicentre single-blind randomised crossover trial, 184 patients with drug-refractory permanent (n=91) or paroxysmal (n=93) AF received a VVI(R) or DDD(R) pacemaker respectively and were paced in a randomised sequence with VRS on or off for two months.

The relevance of health related quality of life in paced patients.

With the tremendous advances in cardiac pacing during the past four decades, cardiac pacemaker implantation is now a common clinical procedure. In recent years, the indications for permanent pacemakers have expanded. This increase in reasons for pacing and shift in mode of pacing have been caused by the evolution of pacemaker therapy from a life-saving measure (mortality), to one aimed at improving health-related quality of life (HRQoL).

A randomized study of combining maze surgery for atrial fibrillation with mitral valve surgery.

Aim: Mitral valve surgery seldom suppresses atrial fibrillation (AF), present prior to surgery. Maze III surgery eliminates AF in >80% of cases, the reason why combining this procedure with mitral valve surgery in patients with AF seems worthwhile. We prospectively studied the outcome of combining the Maze III procedure with mitral valve surgery.

[Implanted pacemakers in the Netherlands, 1984-1997; number, types and patient characteristics].

Objective: To carry out a survey of the numbers of patients in the Netherlands who received a pacemaker in 1984-1997 and the types of pacemaker.

Design: Retrospective, descriptive.

Method: Information on pacemaker patients and pacemakers in the Netherlands during the years 1984-1997 was obtained from the Dutch Pacemaker Patient Registration organisation and those in 15 other West-European countries from the European Working Group on Cardiac Pacing.

Changes in quality-of-life after pacemaker implantation: responsiveness of the Aquarel questionnaire.

Before being introduced for widespread use, health status instruments should be evaluated for reliability, validity, and responsiveness to relevant clinical changes. In a previous study the validity and reliability of Aquarel, a disease-specific quality-of-life (QOL) questionnaire for pacemaker patients, were tested and found satisfactory. The purpose of this study was to assess the sensitivity to change in health of Aquarel.

Psychometric properties of Aquarel. a disease-specific quality of life questionnaire for pacemaker patients.

In cardiac pacing current clinical practice permits the use of ventricular or atrioventricular-synchronous pacemakers. However, it is not known which type of pacemaker results in superior clinical and patient outcomes. To date, there is no feasible and validated disease-specific questionnaire for pacemaker patients to assess quality of life (QoL) available.

Quality-of-life of pacemaker patients: a reappraisal of current instruments.

Current clinical practice permits the use of single chamber ventricular or dual chamber pacemakers. However, it is not known which type of pacemaker results in superior clinical and patient outcomes. This is of growing importance because of the higher costs and increased risk of technical failures of dual chamber pacemakers.

Results of maze surgery for lone paroxysmal atrial fibrillation.

Background: If drug refractoriness to paroxysmal atrial fibrillation (PAF) occurs, arrhythmia surgery that involves channelling and the exclusion of specific atrial areas can abolish atrial fibrillation. The purpose of this study was to establish the effectiveness and safety of maze III surgery to abolish PAF.

Methods And Results: Surgery was performed in 41 selected patients who had long-standing, symptomatic, drug-refractory, lone PAF.