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Optimizing Pacemaker Longevity with Pacing Mode and Settings Programming: Results from a Pacemaker Multicenter Registry

Authors


  • Financial disclosures: Dr. Henri Benkemoun, Dr. Jean Sacrez, Dr. Philippe Lagrange, Dr. Alain Amiel, Dr. Atul Prakash, Dr. Ewald Himmrich, Dr. Ezio Aimè, Dr. Georges H. Mairesse, and Dr. Pascal Sbragia have received research grants from Sorin CRM SAS. Christine Guénon has received salary as Sorin CRM SAS employee.

Address for reprints: Henri Benkemoun, M.D., 80, rue Pascal-Marie Agasse 66000 Perpignan, France. Fax: 33-4-68-56-26-71; e-mail: henri.benkemoun@wanadoo.fr

Abstract

Background: This study aimed to describe the influence on dual-chamber devices' expected longevity of devices' settings.

Methods: Data from patients implanted with dual chamber devices (Symphony™, SORIN CRM SAS, Clamart, France) from 2003 to 2006 were collected in registries. Programmer files were retrieved: device-estimated longevity, assessed through algorithm prediction, was analyzed according to device settings.

Results: One thousand sixty-eight recipients of dual chamber pacemaker in sinus rhythm (75.3 ± 11.1 years, 54.5% male, ventricular block 30%, brady-tachy syndrome 21%, and sinus node dysfunction 49%) were followed up to 14.2 ± 12.1 months (ranging from first quartile Q1: 2.9 months to fourth quartile Q4: 49.3 months) after implantation. DDD with automatic mode conversion and minimized ventricular pacing (SafeR) modes were programmed in 34.3%, 2.9%, and 62.8% of the patients, respectively.

The mean total longevity estimated by the device was 134.1 ± 31.5 months (11.2 ± 2.6 years). Significant increase in longevity was observed in devices undergoing at least one reprogramming (134.4 ± 31.4 months) versus device presenting no reprogramming (103.4 ± 32.3 months, P = 0.0005). The parameters associated with the major increase in mean longevity were the mode (mean longevity increase of +23.9 months in SafeR as compared to DDD mode, P < 0.0001) and the atrial (A) and ventricular (V) amplitudes (mean longevity increase of +29.6 and +26.9 months for a decrease of less than 1V in A and V outputs respectively, P < 0.0001).

Conclusion: This study provides information on dual chamber pacemakers’ longevity and highlights the impact of devices’ reprogramming on expected longevities. PACE 2012; 35:403–408)

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