התמחויות

Two Pacing Alternatives Tested In Sinus-Node Dysfunction

By Elda Hauschildt

Single-chamber ventricular pacing and dual-chamber atrioventricular pacing are alternative options in patients with sinus-node dysfunction requiring permanent pacing for bradycardia. Incidence of death from any cause or non-fatal stroke do not differ significantly between patients randomised to dual-chamber pacing (at 21.5 percent) and those assigned to ventricular pacing (at 23.0 percent), North American researchers report.

They did find a lower incidence of atrial fibrillation and end points related to heart failure among patients in the dual-chamber group, as well as a slightly better quality of life. Investigators from eight United States research centres and one Canadian centre also point out that dual-chamber pacing is both more expensive and more technically complex than single-chamber ventricular pacing.

“We conclude that for patients with sinus-node dysfunction, dual-chamber pacing as compared with single-chamber ventricular pacing did not improve the rate of our primary end point of stroke-free survival,” say researchers from Florida, South Carolina, Massachusetts, New York, Pennsylvania, Missouri, California, Maryland and Ontario, Canada.

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