AI Article Synopsis
- - The study aimed to compare three different pacemaker modes (VVI, VVIR, and DDD) in patients needing dual-chamber stimulation, focusing on those with varying left ventricular function.
- - Two patient groups were analyzed based on their heart function, with assessments on quality of life (QoL), patient preference, and echocardiographic parameters after being switched between modes.
- - Results showed that most patients preferred the DDD mode, which also correlated with better QoL and significant improvements in health outcomes compared to VVI and VVIR modes.
Article Abstract
Background: The aim of this study was to compare VVI, VVIR and DDD modes in patients with indication to dual-chamber stimulation, depending on left ventricular function.
Methods: Two groups of patients were implanted with a DDD pacemaker: Group I with ejection fraction > 40% and Group II with ejection fraction < 40%. Patients with a history of atrial arrhythmia or retrograde conduction were excluded. At follow-up (1 month each) quality of life (QoL), patient preference and echo parameters were collected. At hospital discharge all patients were programmed in DDD for 1 month and then randomized to VVI or VVIR mode. At the end of the period in VVI or VVIR mode each patient underwent a control period in DDD and then was programmed in VVIR or VVI mode.
Results: Seventeen patients out of 23 preferred DDD mode and 6 did not perceive any subjective difference among DDD, VVI and VVIR modes (4/9 in Group I and 2/14 in Group II, p = 0.0017). QoL was significantly different between the two groups and at each follow-up showed the best values in DDD. The correlation between QoL and Tei index was 0.62 in Group I (p < 0.001) and 0.35 in Group II (p = 0.001). Neither ejection fraction nor fractional shortening showed any significant difference during the three phases of the study.
Conclusions: Most patients preferred the DDD mode. The Tei index showed a good correlation with QoL and both QoL and Tei index significantly improved with DDD mode as compared to VVI and VVIR.
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