Clinical implications of elective replacement indicator setting changes in patients with dual‐chamber pacemaker devices

Objective This study sought to determine if single‐chamber operation and/or loss of rate response (RR) during elective replacement indicator (ERI) in patients with dual‐chamber pacemakers lead to increased symptom burden, healthcare utilization, and atrial fibrillation (AF). Background Dual‐chamber...

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Bibliographic Details
Published in:Journal of cardiovascular electrophysiology 2020-10, Vol.31 (10), p.2704-2710
Main Authors: Phillips, Kari A., Ponamgi, Shiva, Mundell, Benjamin, Krushelnytskyy, Mykhaylo, Li, Zhuo, Rea, Robert, Deshmukh, Abhishek, McLeod, Christopher, Espinosa, Raul E., Osborn, Michael, Friedman, Paul A., Mulpuru, Siva K., Cha, Yong‐Mei, Neutzling, Lori B., Munger, Thomas, Kancharla, Krishna, Asirvatham, Samuel J.
Format: Article
Language:English
Subjects:
Congestive heart failure
dual‐chamber pacemaker
Dyspnea
elective replacement indicator
Fibrillation
Intolerance
Pacemakers
Respiration
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Summary:Objective This study sought to determine if single‐chamber operation and/or loss of rate response (RR) during elective replacement indicator (ERI) in patients with dual‐chamber pacemakers lead to increased symptom burden, healthcare utilization, and atrial fibrillation (AF). Background Dual‐chamber pacemakers often change from dual‐ to single‐chamber pacing mode and/or lose RR functionality at ERI to preserve battery. Single‐chamber pacing increases the incidence of heart failure, AF, and pacemaker syndrome suggesting these changes may be deleterious. Methods A retrospective analysis of 700 patients was completed. Three comparisons were analyzed: Comparison 1: mode change and RR loss versus no change; Comparison 2: RR loss only versus no change; Comparison 3: mode change only versus no change (in patients with no RR programmed at baseline). Results In Comparison 1, 121 (46%) patients with setting changes experienced symptoms (most often dyspnea and fatigue/exercise intolerance) versus 3 (4%) without setting changes (p 
ISSN:1045-3873
1540-8167
DOI:10.1111/jce.14677