Arrhythmias & electrophysiologyCohort study
Adverse outcomes due to atrioventricular synchrony loss induced by temporary VVI pacing in patients with pre-existing DDD stimulation: insights from a device recall scenario
- Prospective observational study
- natural experiment (device recall)
- Ventricular pacing >88% throughout
- Clinical events tracked for 12 months
Authors' conclusion
Temporary loss of AV synchrony in chronically DDD-paced patients was associated with rapid, severe, and only partially reversible clinical and echocardiographic deterioration.
Study context
- Population
- Patients in sinus rhythm chronically adapted to DDD stimulation with recalled DDD pacemakers (79.9 ± 16.0 years; 63.4% atrioventricular (AV) block)
- Participants
- 93 patients
- Exposure
- Temporary VVI/VVIR pacing vs subsequent DDD restoration
- Outcome
- Changes in LVEF and heart failure (HF) hospitalizations
Main finding
As reported in the abstract
HF hospitalizations
P < 0.001
| Outcome | VVI/VVIR | DDD | P value |
|---|---|---|---|
| LVEF (from 57.3% baseline) | 53.0% | Not reported in the abstract | |
| LVEF after restoration | Not reported in the abstract | 54.8% |
- Left ventricular ejection fraction (LVEF) decline from 57.3% to 53.0% during VVI/VVIR
- P < 0.001
- After DDD restoration LVEF 54.8%, still significantly worse than baseline
- P < 0.05
Observational data: associations, not effects.
Secondary outcomes
BNP
- BNP increase from 155 to 260 pg/mL during VVI/VVIR
- P < 0.001
- BNP decreased to 210 pg/mL after DDD restoration, still significantly worse than baseline
- P < 0.05
Original publication
Adverse outcomes due to atrioventricular synchrony loss induced by temporary VVI pacing in patients with pre-existing DDD stimulation: insights from a device recall scenario. Europace. Published 7 April 2026. doi:10.1093/europace/euag068
Summarised from the published abstract; every number is checked against it