Author/Editor		Žižek, David; Lipar, Luka; Zupan, Igor; Gabrijelčič, Tone
Title		Primerjava preddvorno-prekatne in sinhrone prekatne elektrostimulacije srca pri bolnikih s stalnimi srčnimi spodbujevalniki
Translated title		Comparison of dual chamber pacing and single lead VDD pacing in patients with permanent pacemaker
Type		članek
Source		Med Razgl
Vol. and No.		Letnik 43, št. 1
Publication year		2004
Volume		str. 19-31
Language		slo
Abstract		VDD pacing systems are an alternative to DDD pacing systems in patients with atrioventricular (AV) block and normal sinus node function. Our study compared atrial sensing, ventricular stimulation threshold, AV synchrony, ventricular lead impedance and quality of life in patients with VDD and DDD pacing systems. It was assumed that there are differences concerning electrostimulation and hemodynamic support between VDD and DDD pacing systems. Ninety-six patients with implanted VDD or DDD pacing systems were enrolled prospectively into our study in 2000. The obtained data was statistically analysed using Student's t-test for independent samples or Mann-Whitney's t-test for two independent samples. Atrial sensing was significantly lower with the VDD system compared to the DDD system, at implantation and at present evaluation (p < 0.001). The ventricular pacing threshold for the VDD system at implantation was significantly lower than for the DDD system (p < 0.02). At the present evaluation, there was no significant difference between VDD and DDD systems (p = 0.49). AV synchrony was statistically lower with VDD systems compared to DDD systems (p < 0.001). The difference between the values of ventricular lead impedance at implantation and at the present evaluation was significantly lower for VDD systems compared to DDD systems (p < 0.001). The quality of life did not differ significantly between VDD and DDD pacing systems (p = 0.96). VDD pacing systems are reliable and safe concerning electrostimulation. However, hemodynamic support is better with DDD pacing systems.
Summary		Sinhrona prekatna stimulacija (VDD) je alternativa sekvenčno preddvorno-prekatni stimulaciji (DDD) pri bolnikih s preddvorno-prekatnim blokom in normalno funkcijo sinusnega vozla. Pri spodbujevalnikih tipa VDD in DDD smo primerjali zaznavanje preddvorov, prag prekatne stimulacije, preddvorno-prekatno usklajenost ter impedanco stimulacije in kakovost življenja. Preveriti smo želeli tudi hipotezo, da med spodbujevalniki tipa VDD in DDD obstajajo razlike, ki so pomembne glede zanesljivosti elektrostimulacije in hemodinamske učinkovitosti. V pregledno raziskavo smo vključili 96 preiskovancev, ki so jim leta 2000 vsadili srčni spodbujevalnik tipa VDD ali DDD. Rezultate smo statistično obdelali s Studentovim testom t za neodvisne vzorce ali testom t za dva neodvisna vzorca po Mann-Whitneyju. Zaznavanje v preddvoru je bilo ob vsaditvi pri tipu VDD statistično značilno nižje kot pri tipu DDD (p < 0,001). Enako razmerje smo ugotovili tudi ob kontroli. Prag prekatne stimulacije je bil ob vsaditvi pri tipu VDD statistično značilno nižji kot pri tipu DDD (p<0,02). Ob kontroli med pragom stimulacije pri tipu VDD in DDD ni bilo statistične razlike (p = 0,49). Pri tipu VDD je bila preddvorno-prekatna usklajenost statistično značilno nižja kot pri tipu DDD (p < 0,001). Razlika v vrednostih impedance ob vsaditvi in ob kontroli je bila pri tipu VDD značilno nižja od enake razlike pri tipu DDD (p < 0,001). Kakovost življenja je bila pri preiskovancih s spodbujevalnikom tipa VDD praktično enaka kot pri tipu DDD (p = 0,96). Lahko zaključimo, da je VDD-stimulacija sicer zanesljiva in varna, vendar hemodinamsko manj ugodna kot DDD.
Descriptors		HEART BLOCK CARDIAC PACING, ARTIFICIAL PACEMAKER, ARTIFICIAL PERCEPTION SENSORY THRESHOLDS ELECTRIC IMPEDANCE HEART ATRIUM HEART VENTRICLE QUALITY OF LIFE