Arrhythmias & electrophysiology
Dual- vs Single-Chamber Ventricular Pacing in Isolated Congenital Complete Atrioventricular Block in Infancy
Authors' conclusion
DDD pacing increases LV dysfunction risk compared with VVI in infants with CCAVB. Single-chamber LV apical pacing should be considered in infants with isolated CCAVB who require pacing. There is a high risk of pacing-related complications, particularly with an increased risk of ventricular lead complications in low-weight neonates.
Study context
- Population
- Infants with isolated congenital complete atrioventricular block (CCAVB) and pacemaker implant at <1 year, with single-site ventricular pacing and no significant congenital heart disease, 2006–2023infants (64% autoimmune CCAVB)
- Participants
- 109 infants
- Exposure
- Dual- vs single- chamber pacing
- Outcome
- Complications
- Follow-up
- Median 5 years
Main finding
As reported in the abstract
60 complications occurred in 47 subjects
43.1%
Observational data: associations, not effects.
Further findings
Clinically significant LV dysfunction · median follow-up of 5 years · more frequent in DDD
P = 0.006
- Clinically significant left ventricular (LV) dysfunction — Overall LV dysfunction
- 11 (10.1%)
- Clinically significant LV dysfunction — LV dysfunction resulted in mortality
- 1 patient
- Clinically significant LV dysfunction — Required a change in pacing mode
- 10 patients
Clinically significant LV dysfunction · median follow-up of 5 years
- Independent risk factors for LV dysfunction: DDD pacing and neonatal implant
LV dysfunction by right ventricular pacing lead placement
- Right ventricular pacing lead placement HR for LV dysfunction
- HR: 2.67
- Not statistically significant (P = 0.20)
Original publication
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