Atrioventricular sequential pacemakers: indications, complications, and long-term follow-up.

Our experience with 32 patients with atrioventricular (AV) sequential pacemakers and an average follow-up of 22 months is presented. The pertinent literature and physiology are reviewed. The indications, advantages, and complications of AV sequential pacemakers are analyzed. Half of the patients required bifocal pacing for control of arrhythmia alone, while half required control of arrhythmia associated with congestive heart failure due primarily to a noncompliant left ventricle. It is anticipated that the hemodynamic improvement occurring as a results of AV sequential pacing will increase the use of this mode of cardiac pacing in selected patients.