Single chamber or dual chamber pacemaker? Cardiology Basics

Single chamber or dual chamber pacemaker? Cardiology Basics The decision between single chamber and dual chamber pacemaker though important based on cost, device longevity and complication wise, is not that easy to make. I am trying to summarize based on the 2018 American College of Cardiology/American Heart Association/Heart Rhythm Society guidelines on this aspect [1]. In underprivileged regions, given an option, there is always a potential bias towards single chamber devices as they are cheaper, tend to have more battery life, easier to implant and likely to have lesser procedure and lead related issues. In symptomatic sinus node dysfunction, with correlation between symptoms and bradycardia, permanent pacing is a Class I indication. There is no cutoff of heart rate or length of pause as an indication for pacing in sinus node dysfunction. If need for pacing is likely to  very infrequent or the patient has significant comorbidities reducing survival, single chamber ventricular pacing has been given a Class IIa recommendation in symptomatic sinus node dysfunction. In others, AV conduction has to be assessed and check whether there is a reason to avoid a right ventricular lead as borderline left ventricular function. If AV conduction is intact and there is reason to avoid an RV lead, single chamber atrial pacing has been given a Class I recommendation. Atrial based pacing can lower the chance of atrial fibrillation. It may be noted that even in those with currently intac...
Source: Cardiophile MD - Category: Cardiology Authors: Tags: General Cardiology Source Type: blogs