Optimizing pacemaker longevity with pacing mode and settings programming: results from a pacemaker multicenter registry

Pacing Clin Electrophysiol. 2012 Apr;35(4):403-8. doi: 10.1111/j.1540-8159.2011.03318.x. Epub 2012 Feb 6.

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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Aged, 80 and over
  • Algorithms
  • Bradycardia / therapy
  • Cardiac Pacing, Artificial / methods
  • Female
  • Heart Block / therapy
  • Humans
  • Male
  • Middle Aged
  • Pacemaker, Artificial*
  • Retrospective Studies
  • Sick Sinus Syndrome / therapy
  • Syndrome
  • Tachycardia / therapy