Non-physiological Increase of AV Conduction Time in Sinus Disease Patients Programmed in AAIR-based Pacing Mode

Overview

Journal J Interv Card Electrophysiol

Publisher Springer

Date 2012 Jul 28

PMID 22836479

Citations 1

Authors

Philippe Mabo

Jean-Pierre Cebron

Aude Solnon

Aude Tassin

Laurence Graindorge

Daniel Gras

Affiliations

Soon will be listed here.

Abstract

Purpose: The EVOCAV(DS) trial aimed to quantify the paradoxal atrioventricular (AV) conduction time lengthening in sinus node (SD) patients (pts) paced in AAIR-based pacing mode.

Methods: SD pts, implanted with dual-chamber pacemaker programmed in AAIR-based pacing mode, were randomized in two arms for a 1-month period: the low atrial pacing (LAP; basic rate at 60 bpm, dual sensor with minimal slope) and the high atrial pacing (HAP; basic rate at 70 bpm, dual sensor with optimized slope, overdrive pacing) arm. At 1 month, crossover was performed for an additional 1-month period. AV conduction time, AV block occurrence and AV conduction time adaptation during exercise were ascertained from device memories at each follow-up.

Results: Seventy-nine pts participated to the analysis (75 ± 8 years; 32 male; PR = 184 ± 38 ms; bundle branch block n = 12; AF history n = 36; antiarrhythmic treatment n = 53; beta-blockers n = 27; class III/Ic n = 18; both n = 8). The mean AV conduction time was significantly greater during the HAP (275 ± 51 ms) vs. LAP (263 ± 49 ms) period (p < 0.0001). Class III/Ic drugs were the only predictors of this abnormal behaviour. Degree II/III AV blocks occurred in 49 % of pts in the HAP vs. 19 % in the LAP period (p < 0.0001). Fifty-two patients (66 %) presented a lengthening of AV conduction time during exercise.

Conclusion: AAIR-based pacing in SD pts may induce a significant lengthening of pts' AV conduction time, including frequent abnormal adaptation of AV conduction time during exercise.

Citing Articles

Minimizing right ventricular pacing in sinus node disease: Sometimes the cure is worse than the disease.

De Maria E, Olaru A, Cappelli S World J Clin Cases. 2015; 3(3):206-9.

PMID: 25789293 PMC: 4360492. DOI: 10.12998/wjcc.v3.i3.206.

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