Article Text

PDF

Left atrial appendage function during DDD and VVI pacing.
  1. E. N. Simantirakis,
  2. F. I. Parthenakis,
  3. S. I. Chrysostomakis,
  4. E. G. Zuridakis,
  5. N. E. Igoumenidis,
  6. P. E. Vardas
  1. Cardiology Department, University Hospital of Heraklion, Crete, Greece.

    Abstract

    OBJECTIVE: To examine, using transoesophageal echocardiography, the possible disturbances of left atrial appendage function during VVI and DDD pacing in patients with a normal atrium paced with a dual chamber system. DESIGN: Randomised controlled trial. SETTING: Tertiary care centre. PATIENTS: 22 patients (mean age 68 (SD 6) years) who had been paced with dual chamber pacemakers for at least six months. Exclusion criteria were valvar disease, cardiomyopathy, hypertension, and diabetes mellitus. INTERVENTIONS: All patients underwent a transoesophageal echocardiographic evaluation of left atrial appendage function under DDD and VVI modes in random order. Measurements were made after at least two months' pacing in each mode. MAIN OUTCOME MEASURES: Echocardiographic indices of left atrial appendage flow under both pacing modes. RESULTS: All 22 patients had higher emptying and filling flow velocities under DDD than under VVI mode. The filling and emptying flow velocity integrals were also significantly higher under DDD mode (P < 0.001, P = 0.019). CONCLUSIONS: Left atrial appendage function, as reflected in indices of emptying and filling assessed by transoesophageal echocardiography, is significantly different with DDD than with VVI pacing. This may explain the higher incidence of thromboembolic episodes in patients paced under VVI mode.

    Statistics from Altmetric.com

    Request permissions

    If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.