RT-201
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Role of DDDR pacing in dual
chamber ICD systems
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Enrico Adornato, Elena Maria
Fernanda Adornato, Luca Rossetti*.
Divisione di Cardiologia, Ospedali Riuniti, Reggio Calabria, *Guidant Italia, Milan, Italy
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Introduction
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The efficacy of implantable cardioverter defibrillator
(ICD) in preventing sudden cardiac death has been shown by several clinical trials. In
patients with symptomatic brady-arrhythmias, in whom a permanent pacemaker is required,
the value of rate adaptive pacing to reproduce the heart's normal chronotropic response to
all daily activities has become widely recognized; in fact the increase in heart rate is
the most important contribution for increasing cardiac output during exercise according to
the metabolic needs. Rate adaptive pacing, compared to fixed rate ventricular pacing, has
been proved to offer a hemodynamic advantage1-6 and an
improvement in quality of life7-10. Several symptoms
are associated with VVI pacing, and the most highly significant are shortness of breath,
dizziness and fatigue. Pacemaker syndrome is clinically recognized in 83% of patients
paced in the VVI mode and almost 65% of them experience moderate to severe symptoms11. The benefits of DDD and DDDR pacing for ICD patients
and how to choose the appropriate device for each patient are described in this review.
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