The Research For The Necessity And Feasibility Of Pacemaker Upgrade From VVI To DDD

OBJECTIVE To discuss the necessity and the related technical details of device upgrade from VVI(R) to DDD(R), and primarily explore the adaption objects and the opportunity of the hardware optimization. METHOD The study enrolls 85 VVI pacemaker patients consecutively from August 1999 to March 2006,in which 32 cases received pacemaker optimization to DDD(R),and another 53 patients accepted purely VVI replacement.There was no significant differences in the clinical features between the two groups.To compare the time-consumption of operation, cost and technical details, and evaluate the structure and function of heart,the risk of pacing-related complications and all kinds of arrhythmia ,the quality of life (QOL) and so on. To analyse possible correlative factors of the targets with remarkable difference by multivariate linearity regression. RESULT Compared with the control group: optimized group consumes more operation-time (40.53～31.37 min), and has higher rate of the new pocket manufacture and ventricle electrode replacement, and more easily occurs complications in operation. The diameter of left atrium(LA) and right atrium (RA),left ventricle at the end of diastole diameter (LVDd),thetricuspid valve regurgitation (TR) obviously reduce ,while fractional shortening(FS)and ejection fraction(EF)significantly increase.There is lower incidence of atrial arrhythmias and ventricular tachycardia (VT)in the Optimized group, and former has statistics difference. The QOL and overall heart function are superior to the contrast group.There is higher occurrence of complications during post-operation in optimized group ,but the apoplexy is less . Drug use and re-hospitalized times has no statistical difference between the two groups.Compared with own pre-operation in optimized group:after pacemaker upgrade, LA,RA,LVDd,TR and the diameter of right ventricle(RV) markedly reduce , while FS and EF obviously increase .DDD mode prevents the onset of VT ,atrail flutter(AF) , atrial tachycardia(AT) and atrail extrastimulus(AE), and seems to develop ventricular extrastimulus(VE) and atrial fibrillation(Afi), but there is no statistics difference.DDD contributes to reduction of the risk of total complication and apoplexy .There is no obvious difference about the...