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VOLUME 7 , ISSUE 1 ( January-April, 2022 ) > List of Articles

RESEARCH ARTICLE

Single-center Experience of AAIR Pacemakers for Sinus Node Dysfunction

Rajeev Sharma, Archit Dahiya, Manas Thakur, Piyush Joshi, Aniruddh Pratap

Keywords : AAIR, Pacemaker, Sinus node dysfunction

Citation Information : Sharma R, Dahiya A, Thakur M, Joshi P, Pratap A. Single-center Experience of AAIR Pacemakers for Sinus Node Dysfunction. J Mahatma Gandhi Univ Med Sci Tech 2022; 7 (1):4-6.

DOI: 10.5005/jp-journals-10057-0192

License: CC BY-NC 4.0

Published Online: 31-08-2022

Copyright Statement:  Copyright © 2022; The Author(s).


Abstract

Introduction: The choice of pacing mode in sinus node dysfunction in patients is still up for debate. Patients with atrial pacing (AAI/AAIR) in comparison to ventricular pacing (VVI/VVIR) have fewer chances of developing atrial fibrillation, stroke, and heart failure. Dual-chamber pacing (DDD/DDDR) is also associated with significantly less atrial fibrillation and less heart failure hospitalization, but various trials have failed to show a survival benefit in relation to ventricular pacing alone. We report about the use of AAIR pacemaker implantation for sinus node dysfunction in 15 adult patients and analyze the clinical characteristics and short-term outcomes of these patients. Materials and methods: All adult patients (18 years or above) who underwent AAIR pacemaker implantation for sinus node dysfunction at the Department of Cardiology, Mahatma Gandhi Hospital, Jaipur between 1st June 2018 and 31st August 2021 were included in the study for retrospective analysis of clinical characteristics and short-term outcome of these patients. This was a retrospective observational study. Prior approval was taken before the start of the study from the Institute Ethics Committee. Results: In our study, the mean age was 63 years and 66% of patients were females. Hypertension was present in 46% of patients and diabetes was seen in 33% of patients. About 26% of patients were having coronary artery disease (CAD). The mean LVEF in the study was 54%. Regarding the indication of AAIR pacemaker, 26% had inappropriate sinus bradycardia, 53% had significant sinus pause, and 20% had bradycardia-tachycardia syndrome. The procedure-related complication was not reported in our study. No change in the pacing mode was required in all 15 patients. Two patients developed episodes of paroxysmal AF on follow-up. No deaths were reported on short-term follow-up. Conclusion: The development of AV blocks is rare in sinus node dysfunction patients. The optimal choice of pacing in these patients is the atrial (AAI/AAIR) pacemaker. It is the safest and provides the best cost-to-benefit ratio when compared to a dual-chamber pacemaker. Hence, atrial pacing should be preferred in sinus node dysfunction patients in the absence of atrioventricular blocks.


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