No statistically significant difference was found between the pacing modes for mortality , heart failure , stroke , chronic atrial fibrillation or quality of life .
However , the risk of developing heart failure may vary with age and device .
The risk of heart failure may have an impact on the decision to use dual-chamber or single-chamber atrial pacemakers .
Results from an analysis based on age ( > 75 years or ≤ 75 years ) and risk of heart failure indicate that dual-chamber pacemakers dominate single-chamber atrial pacemakers ( i.e. are less expensive and more effective ) in older patients , whereas dual-chamber pacemakers are dominated by ( i.e. more expensive and less effective ) single-chamber atrial pacemakers in younger patients .
In patients with SSS without evidence of impaired AV conduction , dual-chamber pacemakers appear to be cost-effective compared with single-chamber atrial pacemakers .
BACKGROUND Bradycardia [ resting heart rate below 60 beats per minute ( b.p.m . ) ]
can be caused by conditions affecting the natural pacemakers of the heart , such as sick sinus syndrome ( SSS ) and atrioventricular ( AV ) blocks .
People suffering from bradycardia may present with palpitations , exercise intolerance and fainting .
The only effective treatment for patients suffering from symptomatic bradycardia is implantation of a permanent pacemaker .
OBJECTIVE To appraise the clinical effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber atrial pacemakers for treating symptomatic bradycardia in people with SSS and no evidence of AV block .
DDD(R)-pacing, but not AAI(R)-pacing induces left ventricular desynchronization in patients with sick sinus syndrome: tissue-Doppler and 3D echocardiographic evaluation in a randomized controlled comparison.
AIMS Increasing evidence from r and omized trials and experimental studies indicates that right ventricular ( RV ) pacing may induce congestive heart failure . We studied regional left ventricular ( LV ) dyssynchrony and global LV function in 50 consecutive patients with sick sinus syndrome ( SSS ) r and omized to either atrial pacing [ AAI(R ) ] or dual chamber RV-pacing [ DDD(R ) ] .  METHODS AND RESULTS Fifty consecutive patients were r and omized to AAI(R ) or DDD(R)-pacing .  Tissue-Doppler imaging was used to quantify LV dyssynchrony in terms of number of segments with delayed longitudinal contraction ( DLC ) . Left ventricular ejection fraction ( LVEF ) was measured using three-dimensional echocardiography . Dyssynchrony was more pronounced in the DDD(R)-group than in the AAI(R)-group at the 12 months follow-up ( P < 0.05 ) . This reflected a significant increase of dyssynchrony in the DDD(R)-group from baseline to the 12 months follow-up ( 1.3 + /- 1 to 2.1 + /- 1 segments displaying DLC per patient ) , P < 0.05 . No change was observed in the AAI(R)-group ( 1.6 + /- 2 to 1.3 + /- 2 segments displaying DLC per patient , NS ) . No difference in LVEF , NYHA or NT-proBNP was observed between AAI(R)- and DDD(R)-mode after 12 months of pacing although LVEF decreased significantly in the DDD(R)-group from baseline ( 63.1 + /- 8 % ) to the 12 months follow-up ( 59.3 + /- 8 % , P < 0.05 ) , while LVEF remained unchanged in the AAI(R)-group ( 61.5 + /- 11 % at baseline vs. 62.3 + /- 7 % after 12 months , NS . CONCLUSION In patients with SSS , DDD(R)-pacing but not AAI(R)-pacing induces significant LV desynchronization and reduction of LVEF
No statistically significant difference was found between the pacing modes for mortality , heart failure , stroke , chronic atrial fibrillation or quality of life .
However , the risk of developing heart failure may vary with age and device .
The risk of heart failure may have an impact on the decision to use dual-chamber or single-chamber atrial pacemakers .
Results from an analysis based on age ( > 75 years or ≤ 75 years ) and risk of heart failure indicate that dual-chamber pacemakers dominate single-chamber atrial pacemakers ( i.e. are less expensive and more effective ) in older patients , whereas dual-chamber pacemakers are dominated by ( i.e. more expensive and less effective ) single-chamber atrial pacemakers in younger patients .
In patients with SSS without evidence of impaired AV conduction , dual-chamber pacemakers appear to be cost-effective compared with single-chamber atrial pacemakers .
BACKGROUND Bradycardia [ resting heart rate below 60 beats per minute ( b.p.m . ) ]
can be caused by conditions affecting the natural pacemakers of the heart , such as sick sinus syndrome ( SSS ) and atrioventricular ( AV ) blocks .
People suffering from bradycardia may present with palpitations , exercise intolerance and fainting .
The only effective treatment for patients suffering from symptomatic bradycardia is implantation of a permanent pacemaker .
OBJECTIVE To appraise the clinical effectiveness and cost-effectiveness of dual-chamber pacemakers compared with single-chamber atrial pacemakers for treating symptomatic bradycardia in people with SSS and no evidence of AV block .