Moríñigo Jose L, Arribas Antonio, Ledesma Claudio, Sánchez Pedro L, Martín Francisco, Martín Luengo Cándido
Servicio de Cardiología. Hospital Clínico Universitario de Salamanca. España.
Rev Esp Cardiol. 2002 Dec;55(12):1267-72. doi: 10.1016/s0300-8932(02)76799-7.
Although atrial pacing is a more physiological mode of stimulation in sinus node dysfunction, the pacing modes most often are used DDD and VVI. The aim of our study was to demonstrate that AAI/AAIR pacing is effective and safe by analyzing the complications and mortality of this pacing mode in a long-term follow-up study.
Between 1982 and 2000 definitive AAI-mode pacemakers were implanted for sinus node dysfunction in mode AAI in 160 patients. We analyzed the clinical characteristics, evolution, and complications of the AAI pacing mode during a follow-up of 5.4 4.5 years.
The sample was made up of 104 women and 56 men with an average age of 72 12 years. During follow-up, it was necessary to change the pacing mode for symptomatic bradycardia in 11 patients (annual incidence 1.2%), which was caused by second or third-degree atrioventricular block in 7 patients (annual incidence 0.8%), and chronic atrial fibrillation with bradycardia in 4 patients (annual incidence 0.4%). During follow-up, atrial arrhythmias occurred in 32 patients (annual incidence 3.7%), stroke in 4 patients (annual incidence 0.4%), and 27 patients (annual incidence 3.1%) died.
The AAI/AAIR pacing mode was safe and effective in sinus node dysfunction, with a low percentage of pacing changes required for progression to atrioventricular block, low incidence of atrial arrhythmias, stroke and low mortality during long term follow-up.
尽管心房起搏在窦房结功能障碍中是一种更符合生理的刺激模式，但最常用的起搏模式是DDD和VVI。我们研究的目的是通过在一项长期随访研究中分析这种起搏模式的并发症和死亡率，来证明AAI/AAIR起搏是有效且安全的。
在1982年至2000年期间，160例窦房结功能障碍患者植入了确定为AAI模式的起搏器。我们在5.4±4.5年的随访期间分析了AAI起搏模式的临床特征、演变及并发症。
样本包括104名女性和56名男性，平均年龄为72±12岁。在随访期间，11例患者（年发生率1.2%）因症状性心动过缓需要改变起搏模式，其中7例（年发生率0.8%）是由二度或三度房室传导阻滞引起，4例（年发生率0.4%）是由慢性心房颤动伴心动过缓引起。在随访期间，32例患者（年发生率3.7%）发生房性心律失常，4例患者（年发生率0.4%）发生中风，27例患者（年发生率3.1%）死亡。
AAI/AAIR起搏模式在窦房结功能障碍中是安全有效的，进展为房室传导阻滞所需的起搏模式改变比例低，房性心律失常、中风发生率低，长期随访期间死亡率低。
