Schuchert A, van Langen H, Michels K, Meinertz T
Medizinische Klinik und Poliklinik Abteilung für Kardiologie, Universitäts-Krankenhaus Eppendorf, Hamburg.
Z Kardiol. 1996 Apr;85(4):248-54.
The programming of dualchamber pacemakers to DDD(R) mode is not recommended in patients with paroxysmal atrial fibrillation/flutter, because the pacemaker detects atrial fibrillation/flutter and paces the ventricle up to the pacemaker's upper tracking rate. Some newer pacemakers have the feature to switch automatically from DDD(R) to DDIR mode at the onset of atrial tachyarrhythmias. The aim of the study was to assess how many patients who received such a new DDDR pacemaker with automatic mode switch can be programmed to DDD(R) mode during follow-up. The dual-chamber pacemaker Thera DR (Medtronic) was implanted for clinical evaluation in 142 patients (65 +/- 16 years, male n = 86; female n = 56). Paroxysmal atrial fibrillation/flutter was present in 54 patients, with an additional 2nd or 3rd degree AV-block in 13 and no high-degree AV block in 22 cases; an AV node ablation was performed in 19 patients. Pacemakers were programmed to DDD(R) mode at discharge in 52 of 53, at month 1 in 44 of 46, and at month 3 in 28 of 30 cases. In respect to the programming to DDD(R) mode there were no statistically significant differences to patients without paroxysmal atrial fibrillation/flutter.
Paroxysmal atrial fibrillation/flutter was present in 38% of the studied patients. During follow up more than 90% of the patients were paced in the DDD(R) mode.
对于阵发性心房颤动/扑动患者，不建议将双腔起搏器程控为DDD(R)模式，因为起搏器会检测到心房颤动/扑动并以起搏器的上限跟踪频率对心室进行起搏。一些新型起搏器具有在房性快速心律失常发作时自动从DDD(R)模式切换到DDIR模式的功能。本研究的目的是评估在随访期间，接受具有自动模式切换功能的新型DDDR起搏器的患者中有多少可以程控为DDD(R)模式。142例患者（65±16岁，男性86例；女性56例）植入双腔起搏器Thera DR（美敦力公司）进行临床评估。54例患者存在阵发性心房颤动/扑动，其中13例伴有二度或三度房室传导阻滞，22例无高度房室传导阻滞；19例患者进行了房室结消融。53例中的52例、46例中的44例以及30例中的28例在出院时、第1个月和第3个月分别将起搏器程控为DDD(R)模式。在程控为DDD(R)模式方面，与无阵发性心房颤动/扑动的患者相比无统计学显著差异。
在所研究的患者中，38%存在阵发性心房颤动/扑动。在随访期间，超过90%的患者以DDD(R)模式起搏。
