Forty-nine patients, including 38 with documented bradysystolic sick-sinus syndrome (type I) and 11 with bradytachycardiac sick-sinus syndrome (type II) were studied. Follow-up of 24 patients with VVI stimulation (34 +/- 4 months) and 7 patients with AAI stimulation (23 +/- 1.2 months) demonstrated that VVI stimulation was associated with retrograde ventriculo-atrial conduction in 71% of patients, causing paroxysms of atrial fibrillation (5 patients, 4 of those having type I sick-sinus syndrome). Six patients developed permanent atrial fibrillation (including 5 with type I sick-sinus syndrome). Retrograde conduction slowed down the pulse rate because of ineffective ventricular response in 6 patients. Nine patients with retrograde conduction developed circulatory insufficiency.

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