From the Department of Cardiology, Skejby Sygehus, Aarhus University
Hospital, Aarhus, Denmark.
Correspondence to Henning Rud Andersen, MD, DMSc, Department of Cardiology, Skejby Sygehus, Aarhus University Hospital, 8200 Aarhus N, Denmark.
Background—It has been claimed
that patients with sick sinus syndrome have an increased risk of
developing AV block, but this has never been assessed prospectively.
The aim of the present study was to evaluate in a prospective trial
AV conduction during the long-term follow-up of patients with sick
sinus syndrome.
Methods—Two hundred twenty-five consecutive patients with sick
sinus syndrome and intact AV conduction were randomized to undergo
single-chamber atrial pacing (110 patients) or single-chamber
ventricular pacing (115 patients). Follow-up after 3 months
and then yearly included measurement of the PQ interval and, in
patients with atrial pacemakers, determination of the atrial
stimulus–Q intervals at pacing rates of 100 and 120 bpm. The
occurrence of AV block in the atrial group was recorded. During
follow-up (mean, 5.5±2.4 years), there was no change in PQ interval in
either group and no change in atrial stimulus–Q intervals or
Wenckebach block point in the atrial group. Four of 110 patients in the
atrial group developed grade 2 to 3 AV block that required upgrading of
the pacemaker (0.6% per year). Two of these 4 patients had right
bundle-branch block at pacemaker implantation.
Conclusions—AV conduction, estimated as PQ interval and atrial
stimulus–Q interval at atrial pacing rates of 100 and 120 bpm and the
Wenckebach block point, remains stable during long-term follow-up.
Thus, treatment with single-chamber atrial pacing is safe and can be
recommended to patients with sick sinus syndrome without bundle-branch
block.
© 1998 American Heart Association, Inc.
Clinical Investigation and Reports
Atrioventricular Conduction During Long-Term Follow-Up of Patients With Sick Sinus Syndrome
Key Words: sick sinus syndrome • pacing • atrioventricular block • follow-up studies
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